Interpret the ABG results: pH: 7.48, PaCO2: 28 mmHg, PaO2: 55 mmHg, HCO3-: 24 mEq/L, SaO2: 87%

Metabolic alkalosis with hypoxemia

Respiratory alkalosis with hypoxemia

Metabolic acidosis with hypoxemia

Respiratory acidosis with hypoxemia

Answer and Explanation

The Correct Answer is B

Choice A reason: Metabolic alkalosis shows pH >7.45 with HCO3- >26 mEq/L from base excess. Here, pH is 7.48, but HCO3- is normal at 24 mEq/L, ruling out metabolic cause. PaO2 of 55 mmHg indicates hypoxemia, but the primary issue isn’t metabolic.

Choice B reason: Respiratory alkalosis occurs with pH >7.45 and PaCO2 <35 mmHg from hyperventilation. Here, pH is 7.48, PaCO2 is 28 mmHg, and HCO3- is normal, confirming respiratory etiology. PaO2 of 55 mmHg shows hypoxemia, matching this acute ventilatory pattern.

Choice C reason: Metabolic acidosis has pH <7.35 and HCO3- <22 mEq/L from acid gain. Here, pH is 7.48 and HCO3- is 24 mEq/L, contradicting acidosis. PaO2 of 55 mmHg indicates hypoxemia, but the acid-base status is alkalotic, not acidic.

Choice D reason: Respiratory acidosis features pH <7.35 and PaCO2 >45 mmHg from CO2 retention. Here, pH is 7.48 and PaCO2 is 28 mmHg, showing CO2 loss, not retention. Hypoxemia (PaO2 55 mmHg) is present, but the pattern is alkalotic.

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Correct Answer is D

Explanation

Choice A reason: Vasoconstrictors like oxymetazoline shrink vessels, aiding epistaxis control. It’s a secondary step requiring preparation, not first, as direct pressure is faster, non-invasive, and effective for initial hemostasis in most anterior bleeds.

Choice B reason: Packing with a balloon stops severe bleeding but is invasive and later in management. Pressure is the first, simpler action; packing escalates care unnecessarily before basic measures are tried in acute epistaxis.

Choice C reason: Silver nitrate cauterizes vessels, useful for persistent bleeding. It’s not first, requiring setup and assessment after pressure fails, as most epistaxis resolves with compression, making this a subsequent intervention.

Choice D reason: Squeezing nostrils compresses Kiesselbach’s plexus, stopping most anterior nosebleeds within 10 minutes. It’s the immediate, evidence-based first action, non-invasive, and effective, prioritizing rapid control before escalating to other methods.

A. Teach the patient about administration of insulin. B. Give oral hypoglycemic medications before meals. C. Discuss the role of diet in blood glucose control. D. Evaluate the patient’s use of pancreatic enzymes.

Correct Answer is A

Explanation

Choice A reason: CF-related diabetes (CFRD) from pancreatic damage requires insulin, as glucose of 180-250 mg/dL indicates insulin deficiency. Teaching administration addresses this directly, aligning with standard CFRD management for glycemic control.

Choice B reason: Oral hypoglycemics aren’t effective in CFRD, which stems from insulin lack, not resistance. Glucose levels of 180-250 mg/dL need insulin, making this inappropriate for CF’s unique endocrine pathology.

Choice C reason: Diet impacts glucose, but CFRD requires insulin first, not just dietary control. Levels of 180-250 mg/dL exceed dietary management alone, so this is secondary to initiating insulin therapy in CF.

Choice D reason: Pancreatic enzymes aid digestion in CF, not glucose control directly. Evaluating use is routine, but hyperglycemia of 180-250 mg/dL points to CFRD, necessitating insulin over enzyme adjustment.

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Interpret the ABG results: pH: 7.48, PaCO2: 28 mmHg, PaO2: 55 mmHg, HCO3-: 24 mEq/L, SaO2: 87%

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which action would the nurse take first when a patient develops epistaxis (nose bleed)?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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