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 ["A","B","E","G","H"]

Explanation

Choice A reason: Tea, especially caffeinated, relaxes the lower esophageal sphincter, worsening GERD symptoms. Avoiding it shows understanding, making this a correct food the nurse would expect the client to avoid based on dietary education to prevent GERD exacerbation.

Choice B reason: Beer, an alcoholic beverage, irritates the esophagus and relaxes the sphincter, triggering GERD symptoms. Avoiding it reflects correct understanding, making this a correct food the nurse would include in teaching for the client to prevent GERD flare-ups.

Choice C reason: Cheese, while high-fat, is less likely to trigger GERD than alcohol or chocolate. Oatmeal is GERD-friendly, making this incorrect, as it’s not a primary trigger compared to the nurse’s teaching on foods to avoid for GERD symptom management.

Choice D reason: Oatmeal is a bland, high-fiber food that soothes GERD symptoms, not exacerbating them. Avoiding chocolate is correct, making this incorrect, as it’s a beneficial food, unlike the triggers the nurse teaches the client to avoid in GERD management.

Choice E reason: Chocolate contains caffeine and fat, relaxing the esophageal sphincter and worsening GERD. Avoiding it shows understanding, making this a correct food the nurse would expect the client to avoid to prevent symptom exacerbation based on GERD dietary teaching.

Choice F reason: Sweet potatoes are low-fat and non-irritating, not triggering GERD symptoms. Avoiding alcohol is correct, making this incorrect, as it’s a safe food, unlike the nurse’s teaching on foods the client should avoid to manage GERD effectively.

Choice G reason: Alcohol, including beer, relaxes the esophageal sphincter and irritates the mucosa, exacerbating GERD. Avoiding it reflects understanding, making this a correct food the nurse would include in teaching for the client to prevent GERD symptom flare-ups.

Choice H reason: French fries, high in fat, delay gastric emptying and worsen GERD symptoms. Avoiding them shows understanding, making this a correct food the nurse would expect the client to avoid based on dietary education to manage GERD effectively.

A. Stoma is beefy red and shiny. B. Purple discoloration of the stoma. C. Skin excoriation around the stoma. D. Semiformed stool noted in the ostomy pouch.

Correct Answer is B

Explanation

Choice A reason: A beefy red, shiny stoma is normal, indicating healthy tissue perfusion. Purple discoloration suggests ischemia, making this incorrect, as it doesn’t require immediate notification compared to the nurse’s priority of reporting a potentially life-threatening stoma complication to the provider.

Choice B reason: Purple discoloration of the stoma indicates potential ischemia or necrosis, a serious complication requiring immediate provider notification. This aligns with colostomy care priorities, making it the correct observation for the nurse to report promptly to prevent further tissue damage or obstruction.

Choice C reason: Skin excoriation around the stoma is concerning but less urgent than purple discoloration, which signals ischemia. This is incorrect, as it can be managed with barrier creams, unlike the nurse’s priority of addressing a critical stoma issue requiring immediate intervention.

Choice D reason: Semiformed stool in the ostomy pouch is expected post-colostomy and not alarming. Purple discoloration is critical, making this incorrect, as it’s a normal finding compared to the nurse’s need to notify the provider about a potentially ischemic stoma.

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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

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)

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

Explanation

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?

Correct Answer is B

Explanation

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