The nurse caring for a client with chronic obstructive pulmonary disease (COPD) anticipates which arterial blood gas (ABG) findings?

pH: 7.40, PaO2: 90 mm Hg, CO2: 39 mEq/L, HCO3: 23 mEq/L.

pH: 7.32, PaO2: 85 mm Hg, CO2: 57 mEq/L, HCO3: 26 mEq/L.

pH: 7.47, PaO2: 82 mm Hg, CO2: 30 mEq/L, HCO3: 31 mEq/L.

pH: 7.30, PaO2: 95 mm Hg, CO2: 22 mEq/L, HCO3: 19 mEq/L.

Answer and Explanation

The Correct Answer is B

Choice A reason: Normal ABG values (pH 7.40, CO2 39) don’t reflect COPD’s chronic hypercapnia and compensated acidosis. pH 7.32 with elevated CO2 is typical, making this incorrect, as it doesn’t match the nurse’s expected findings in a client with chronic obstructive pulmonary disease.

Choice B reason: In COPD, chronic CO2 retention (57 mEq/L) causes respiratory acidosis (pH 7.32) with compensatory HCO3 increase (26 mEq/L). Low PaO2 (85 mm Hg) reflects hypoxemia. This aligns with COPD pathophysiology, making it the correct ABG finding the nurse anticipates in this client.

Choice C reason: Alkalotic pH (7.47) and low CO2 (30 mEq/L) suggest hyperventilation, not COPD’s CO2 retention. Acidosis with high CO2 is expected, making this incorrect, as it contradicts the typical ABG profile in the nurse’s assessment of a COPD client.

Choice D reason: Low CO2 (22 mEq/L) and acidosis (pH 7.30) suggest metabolic acidosis, not COPD’s respiratory acidosis with hypercapnia. Elevated CO2 is typical, making this incorrect, as it doesn’t reflect the nurse’s expected ABG findings in chronic obstructive pulmonary disease.

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Correct Answer is B

Explanation

Choice A reason: Initiating antibiotics is critical but follows cultures to identify the causative organism. Obtaining cultures first ensures accurate treatment, making this incorrect, as it risks altering culture results if antibiotics are given before sampling in the pneumonia client.

Choice B reason: Obtaining blood and sputum cultures first identifies the pneumonia-causing organism, guiding effective antibiotic therapy. This aligns with infection management protocols, making it the correct initial order to implement for the client admitted with pneumonia to ensure accurate treatment.

Choice C reason: Airborne precautions are needed for specific pneumonias (e.g., tuberculosis), but most require droplet precautions. Cultures guide treatment, making this incorrect, as it’s less urgent than obtaining cultures first to confirm the pathogen in the client with pneumonia.

Choice D reason: An indwelling catheter is unnecessary for pneumonia unless urinary retention is present. Obtaining cultures is the priority, making this incorrect, as it’s irrelevant to the immediate management of the client’s infection compared to identifying the causative organism.

A. Palpation of a thrill over the fistula. B. Presence of a radial pulse in the left wrist. C. Visualization of enlarged blood vessels at the fistula site. D. Capillary refill less than 3 seconds in the nail beds of the fingers on the left hand.

Correct Answer is A

Explanation

Choice A reason: Palpation of a thrill, a vibrating sensation, indicates blood flow and patency in an arteriovenous fistula. This aligns with hemodialysis access assessment, making it the correct finding the nurse would use to confirm the fistula is patent.

Choice B reason: A radial pulse in the wrist is normal but doesn’t confirm fistula patency, which requires a thrill. Palpation of a thrill is specific, making this incorrect, as it’s not a direct indicator of fistula function in hemodialysis preparation.

Choice C reason: Enlarged vessels may suggest fistula development but don’t confirm active flow. A thrill indicates patency, making this incorrect, as it’s less specific than the nurse’s assessment of a palpable thrill over the fistula site.

Choice D reason: Capillary refill less than 3 seconds assesses distal perfusion, not fistula patency. Palpation of a thrill is the standard, making this incorrect, as it’s unrelated to the nurse’s evaluation of the arteriovenous fistula for hemodialysis.

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The nurse caring for a client with chronic obstructive pulmonary disease (COPD) anticipates which arterial blood gas (ABG) findings?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a client with pneumonia. Which of the following orders should be implemented first?

Correct Answer is B

Explanation

The nurse is assessing the patency of a client’s left arm arteriovenous fistula prior to initiating hemodialysis. Which finding indicates that the fistula is patent?

Correct Answer is A

Explanation

The nurse is providing dietary education to a client with gastroesophageal reflux disease (GERD). The nurse indicates that the client understands the teaching if the client states a plan to avoid which foods to prevent symptom exacerbation? (Select all that apply)

The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction?

A nurse is providing teaching to a client who has venous insufficiency of the lower extremities. Which of the following statements by the client indicates an understanding of the teaching?

Which assessment finding on a client with hypervolemia indicates to the nurse that the client’s condition may be worsening?

The nurse is providing care for a client with a bowel obstruction who had a transverse colostomy created. Which observation requires immediate notification of the primary health care provider?