The client is experiencing respiratory acidosis as a result of COPD is likely to present with which of the following clinical signs? (Select 4 options that apply)

dysrhythmias

barrel chest

difficult to arouse

repeatedly asking "Where am I?"

deep, rapid respirations

Answer and Explanation

Correct Answer : A,B,C,D

Rationale:
A. Dysrhythmias may occur due to increased CO₂ levels and acid-base imbalance affecting cardiac conduction.
B. Barrel chest is a common physical finding in clients with chronic COPD due to air trapping and lung hyperinflation.
C. Difficulty arousing the client may indicate CO₂ narcosis, a sign of worsening respiratory acidosis.
D. Confusion and disorientation, such as repeatedly asking "Where am I?", are neurological signs of elevated CO₂ levels.
E. Deep, rapid respirations (Kussmaul respirations) are typical of metabolic acidosis, not respiratory acidosis from COPD.

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Correct Answer is A

Explanation

Rationale:
A. Chvostek’s sign is a clinical indicator of hypocalcemia. It is elicited by tapping the facial nerve in front of the ear, which causes twitching of the facial muscles in clients with low calcium levels due to increased neuromuscular excitability.
B. Brudzinski’s sign indicates meningeal irritation, such as in meningitis, not hypocalcemia.
C. Cullen’s sign is bruising around the umbilicus, associated with intra-abdominal bleeding, not electrolyte imbalance.
D. Kernig’s sign is another sign of meningeal irritation and is unrelated to calcium levels.

A. A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.002 B. A 4-year-old preschooler who has status asthmaticus and a pulse oximetry of 95% C. A 1-year-old infant who has roseola and a temperature of 39°C (102.2°F) D. A 10-year-old child who has sickle cell anemia and a pain rating of 6 on a 0 to 10 scale.

Correct Answer is A

Explanation

Rationale:
A. Diabetes insipidus can lead to profound dehydration due to excessive fluid loss. A urine specific gravity of 1.002 indicates very dilute urine, supporting the concern. This child is at immediate risk for hypovolemic shock, so the nurse should assess them first.
B. A pulse oximetry of 95% is within acceptable range for a child with asthma, suggesting no acute distress at this time.
C. Roseola with a fever of 39°C is expected; while monitoring is needed, it's not the highest priority.
D. Pain of 6/10 in sickle cell anemia is concerning and requires attention, but it is not as emergent as potential fluid imbalance in diabetes insipidus.

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The client is experiencing respiratory acidosis as a result of COPD is likely to present with which of the following clinical signs? (Select 4 options that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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