George, an 85yearold man with a history of chronic obstructive pulmonary disease, was rushed to the emergency department with increasing shortness of breath, restlessness, and difficulty communicating due to his inability to complete a sentence. On assessment, tachycardia and a bounding pulse were noted. Wheezes could be heard in the lower lobes. His blood gas shows a pH of 7.3, PaCO2 of 68 mmHg, HCO3 of 28 mmol/L, and PaO2 of 60 mmHg. How would you interpret this?

Metabolic Acidosis, Uncompensated

Metabolic Acidosis, Partially Compensated

Respiratory Acidosis, Partially Compensated

Respiratory Acidosis, Uncompensated

Answer and Explanation

The Correct Answer is C

Choice A reason: Metabolic acidosis is characterized by a low pH and a low HCO3. However, George's HCO3 is within normal range, indicating that metabolic acidosis is not the primary issue.

Choice B reason: Partially compensated metabolic acidosis would present with a low pH and a low HCO3, along with a low PaCO2 as the body attempts to compensate. George's PaCO2 is elevated, which is not consistent with this condition.

Choice C reason: George's high PaCO2 and near normal HCO3 suggest that his primary issue is respiratory acidosis. The body has begun to compensate by retaining HCO3, making it partially compensated.

Choice D reason: Uncompensated respiratory acidosis would present with an elevated PaCO2 and a normal HCO3. Since George's HCO3 is elevated, it indicates partial compensation.

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Correct Answer is C

Explanation

Choice A reason: This choice is incorrect. Painless, raised purple nodules on the hard palate are not typically indicative of squamous cell carcinoma.

Choice B reason: This choice is incorrect. A small macule with a yellow-brown scale does not describe squamous cell carcinoma, which often presents as a firm nodule with a scaly crust.

Choice C reason: This is the correct choice. Squamous cell carcinoma can present as a firm nodule with a hard, scaly crust on the skin.

Choice D reason: Yellow white patches of growth on the tongue are more indicative of conditions such as oral leukoplakia, not squamous cell carcinoma.

A. Weigh the client daily. B. Restrict fluid intake. C. Administer oral corticosteroids. D. Provide a low carbohydrate diet.

Correct Answer is C

Explanation

Choice A reason: Weighing the client daily is important for monitoring fluid balance but is not the most immediate action to prevent an Addisonian crisis.

Choice B reason: Restricting fluid intake is not appropriate for a client at risk for Addisonian crisis, as they may require increased fluids to prevent dehydration.

Choice C reason: This is the correct action. Clients with Addison's disease require corticosteroids to replace the hormones that their adrenal glands are not producing.

Choice D reason: Providing a low carbohydrate diet is not relevant to the prevention of an Addisonian crisis.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is performing an integumentary assessment for a client. Which of the following findings should the nurse identify as possible squamous cell carcinoma?

Correct Answer is C

Explanation

A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is assessing a male client who has advanced peripheral artery disease (PAD). Which of the following findings should the nurse expect?

A nurse is monitoring a client who is receiving packed RBCs. The nurse identifies which of the following as an expected finding?

A nurse is developing a teaching plan for a client who has a new diagnosis of type 2 diabetes mellitus. Which of the following actions should the nurse plan to take first?

A nurse is assessing a client 15 minutes after administering 2 mg of morphine sulfate via IV push. The nurse should identify which of the following findings as an adverse effect of the medication?

A nurse is planning care for a female client who has a T4 spinal cord injury and is at risk for acquiring urinary tract infections. Which of the following actions should the nurse include in the client's plan of care?

A nurse is providing teaching to a client who has a family history of hypertension. The nurse should inform the client that his blood pressure of 124/79 mm Hg places him in which of the following categories?

A nurse in an emergency department is caring for a patient with a deep laceration on his left lower forearm. After observing standard precautions, which of the following actions should the nurse take?