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 C

Explanation

Choice A reason: Supplemental oxygen is unnecessary with a normal respiratory rate (16) and stable vitals. Maintaining the collar prevents spinal injury, making this incorrect, as it’s not indicated compared to the nurse’s priority of ensuring spinal stability in a client with a fall history.

Choice B reason: Morphine for pain is premature without confirming spinal stability, as it may mask symptoms. Keeping the collar in place is critical, making this incorrect, as it risks missing neurological changes in the nurse’s care of a potential spinal injury client.

Choice C reason: Keeping the hard collar in place until cleared by imaging prevents worsening of potential spinal injury after a trampoline fall. This aligns with trauma care protocols, making it the correct action for the nurse to take to ensure the client’s safety and stability.

Choice D reason: Methylprednisolone is used for confirmed spinal cord injury, not suspected cases without imaging. Maintaining the collar is the priority, making this incorrect, as it’s premature compared to the nurse’s focus on spinal precautions in a client with numbness and tingling.

A. Maintain NPO (nothing by mouth) status. B. Encourage coughing and deep breathing. C. Give small, frequent high-calorie feedings. D. Maintain the client in a supine and flat position. E. Give hydromorphone intravenously as prescribed for pain. F. Maintain intravenous fluids at 10 mL/hr to keep the vein open.

Correct Answer is ["A","B","E"]

Explanation

Choice A reason: NPO status rests the pancreas, reducing enzyme secretion in acute pancreatitis. This aligns with treatment protocols, making it a correct intervention the nurse would expect to be prescribed for the client to manage pancreatic inflammation effectively.

Choice B reason: Coughing and deep breathing prevent respiratory complications like atelectasis in pancreatitis patients, who are often immobile. This aligns with standard care, making it a correct intervention the nurse would anticipate in the client’s treatment plan.

Choice C reason: Small, frequent high-calorie feedings are contraindicated in acute pancreatitis, as they stimulate the pancreas. NPO is correct, making this incorrect, as it’s inappropriate for the nurse’s expected interventions in managing acute pancreatitis.

Choice D reason: Supine and flat positioning may increase discomfort and aspiration risk in pancreatitis. Semi-Fowler’s is preferred, making this incorrect, as it’s not an expected intervention compared to the nurse’s focus on optimal positioning for the client.

Choice E reason: Hydromorphone IV provides effective pain relief in acute pancreatitis, reducing patient discomfort. This aligns with pain management protocols, making it a correct intervention the nurse would expect to be prescribed for the client’s care.

Choice F reason: IV fluids at 10 mL/hr are insufficient for pancreatitis, which requires aggressive hydration. Higher rates are standard, making this incorrect, as it’s inadequate compared to the nurse’s expected fluid management in acute pancreatitis treatment.

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

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? (Select all that apply)

Correct Answer is ["A","B","E"]

Explanation

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