The client with COPD presents in the ER with complaints of worsening SOB since last night. His ABG results are below. How should these results be interpreted?

pH: 7.33

PaCO2: 60

HCO3-:31

PaO2: 75

SaO2: 91%

Compensated metabolic acidosis with hypoxemia

Partially compensated metabolic alkalosis

Partially compensated respiratory acidosis with hypoxemia

Fully compensated respiratory acidosis

Answer and Explanation

The Correct Answer is C

A. Compensated metabolic acidosis with hypoxemia: Metabolic acidosis would show a low pH with low HCO₃⁻, but here the bicarbonate is elevated (31), indicating renal compensation rather than a metabolic cause.

B. Partially compensated metabolic alkalosis: Metabolic alkalosis is characterized by elevated pH and high HCO₃⁻. In this case, the pH is low (7.33), which rules out alkalosis as the primary problem.

C. Partially compensated respiratory acidosis with hypoxemia: The pH is slightly acidic (7.33), PaCO₂ is elevated (60), and HCO₃⁻ is also elevated (31), showing renal compensation. Because the pH has not returned to normal, it is only partial compensation. PaO₂ of 75 and SaO₂ of 91% indicate mild hypoxemia.

D. Fully compensated respiratory acidosis: Full compensation occurs when the pH returns to normal. Since the pH is still below 7.35, the acidosis remains only partially compensated.

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Correct Answer is B

Explanation

A. Symmetrical chest expansion: In a tension pneumothorax, chest expansion is usually asymmetrical because air trapped in the pleural space prevents full lung expansion on the affected side. Symmetrical movement would not be expected in this condition.

B. Tracheal deviation away from the affected side: This is a hallmark sign of tension pneumothorax. As intrapleural pressure increases, the mediastinum shifts, pushing the trachea and other structures toward the unaffected side, which is a medical emergency requiring immediate intervention.

C. Increased breath sounds on the affected side: Breath sounds are typically absent or markedly diminished over the affected lung due to lung collapse. Increased breath sounds would not occur in the presence of trapped air compressing the lung.

D. Hyperresonance to percussion on the affected side: Hyperresonance can occur with a simple pneumothorax due to excess air in the pleural cavity. However, while present, it is not as specific or critical as tracheal deviation, which directly indicates a tension pneumothorax.

A. Ask the patient to participate in family therapy sessions to improve communication B. Provide a structured environment with clear, simple instructions for daily tasks C. Encourage the patient to engage in group therapy to improve social skills D. Administer antipsychotic medication as prescribed to reduce

Correct Answer is B

Explanation

A. Ask the patient to participate in family therapy sessions to improve communication: Family therapy can help reduce stressors and improve relationships, but it is not the most immediate intervention for disorganized speech and impaired functioning.

B. Provide a structured environment with clear, simple instructions for daily tasks: Clients with disorganized thinking benefit from predictability and step-by-step guidance. A structured environment reduces confusion, enhances safety, and helps the patient successfully complete activities of daily living.

C. Encourage the patient to engage in group therapy to improve social skills: Group therapy can be beneficial once the client’s thought processes and functioning are more stabilized. However, in the presence of severe disorganization, participation in group settings may increase frustration and confusion rather than support progress.

D. Administer antipsychotic medication as prescribed to reduce symptoms: Medication is essential for reducing psychotic symptoms, but psychosocial interventions such as structure and clear instructions directly improve functioning.

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The client with COPD presents in the ER with complaints of worsening SOB since last night. His ABG results are below. How should these results be interpreted? pH: 7.33 PaCO2: 60 HCO3-:31 PaO2: 75 SaO2: 91%

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Naxlex Comprehensive Predictor Exams

Which assessment finding indicates a tension pneumothorax, a complication of untreated pneumothorax?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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The client with COPD presents in the ER with complaints of worsening SOB since last night. His ABG results are below. How should these results be interpreted?

pH: 7.33

PaCO2: 60

HCO3-:31

PaO2: 75

SaO2: 91%