Colleen, a 19 year old Freshman, was drinking alcohol at a frat party. She stupors, falls and hits her head on the ground. Her friend Julie dials "911" because Colleen is now unconscious, depressed ventilation (shallow and slow respirations), rapid heart rate, and is profusely bleeding from both ears. Which primary acid-base imbalance is Colleen at risk for if medical attention is not provided?

Metabolic Acidosis

Respiratory Acidosis

Respiratory Alkalosis

Metabolic Alkalosis

Answer and Explanation

The Correct Answer is B

Respiratory acidosis is a primary acid-base imbalance that occurs when there is an excess of carbon dioxide (CO2) in the body due to impaired ventilation or inadequate removal of CO2 from the lungs. In this case, Colleen's depressed ventilation, indicated by shallow and slow respirations, can lead to inadequate elimination of CO2 from her body. The excessive CO2 levels can result in an accumulation of carbonic acid (H2CO3) in the blood, leading to an increase in acidity and a decrease in pH.

The profuse bleeding from both ears indicates a potential head injury, which can lead to decreased neurological function and impaired control over the respiratory center in the brain. This can further contribute to depressed ventilation and the development of respiratory acidosis. Metabolic acidosis, characterized by a decrease in bicarbonate (HCO3-) levels or an increase in non-carbonic acids in the blood, is not the primary acid-base imbalance in this case since the scenario does not provide information indicating a primary metabolic disorder. Respiratory alkalosis, characterized by decreased levels of CO2 in the blood, leading to increased pH and alkalinity, is not the primary acid-base imbalance in this case. The depressed ventilation and associated increase in CO2 levels indicate the opposite, respiratory acidosis. Metabolic alkalosis, characterized by an increase in bicarbonate levels or a decrease in non-carbonic acids, is not the primary acid-base imbalance in this case as the scenario does not provide information indicating a primary metabolic disorder.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

The client's complaint of hemoptysis (coughing up blood) and a positive Mantoux test (4 cm induration) suggest the possibility of tuberculosis (TB) infection. TB is an airborne infectious disease, and placing the client in airborne isolation is necessary to prevent the spread of the infection to others.

Antibiotics may be used to treat tuberculosis, but the initial step would be to isolate the client and confirm the diagnosis before starting specific treatment.

A CT scan may be ordered to further evaluate the client's condition, but it is not the immediate action required in this case. Isolation and confirmation of the diagnosis take priority. While the client may require oxygen therapy based on their respiratory symptoms, it is not the primary action to take at this stage. Isolation and further evaluation are necessary before initiating specific treatments.

A. Relax smooth muscles of the bronchial airway. B. Prevent Infection. C. Suppress the cough. D. Promote Expectoration.

Correct Answer is A

Explanation

Aminophylline is a bronchodilator that belongs to the xanthine derivative class of medications. It works by relaxing the smooth muscles surrounding the bronchial airways, which leads to bronchodilation. By dilating the airways, aminophylline helps to relieve bronchospasm, improve airflow, and facilitate easier breathing.

Prevent Infection: Aminophylline is not an antimicrobial medication, and its primary action is not related to preventing or treating infections.

Suppress the cough: While aminophylline may have some antitussive (cough-suppressing) effects, its primary action is bronchodilation rather than directly suppressing the cough reflex. Promote Expectoration: Aminophylline is not primarily indicated for promoting expectoration (bringing up mucus). It mainly focuses on bronchodilation to improve airflow and relieve bronchospasm.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Aminophylline is prescribed for a client with acute bronchitis. A nurse administers the medication, knowing that the primary action of this medication is to:

Correct Answer is A

Explanation

A patient with a gastric outlet obstruction has been treated with NG decompression. After the first 24 hours, the patient develops nausea and increased upper abdominal bowel sounds. What is the best action by the nurse?

Which condition or changes indicate to the nurse that a patient with a tracheostomy requires suctioning? Select all that apply.

While triaging the wounded from a disaster, you note that one of the wounded is not breathing, radial pulse is absent, capillary refill >2 seconds, and does not respond to your commands. What color tag is assigned?

The nurse caring for a client with systemic lupus erythematosus (SLE) would include which information in teaching about triggers that can result in an exacerbation of the disease?

A nurse practitioner orders 1 liter of 0.9% normal saline to infuse over 6 hours. How many milliliters per hour will the nurse program the IV infusion device? Round off.

A nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD) and is diagnosed with pneumonia. The client has been on a long-term regimen of methylprednisolone. Which precautions should the nurse take to prevent complications? Select all that apply.

The patient who is confined to bed in the supine position has gained 5 lbs. in the last 48 hours. In which area does the nurse assess skin turgor for accurate determination of dependent edema?

What discharge teaching will the nurse provide to a patient who has gastric bypass surgery? Select all that apply.