The nurse is caring for a hospitalized client who is retaining carbon dioxide (CO2) because of respiratory disease. The nurse anticipates which physical response will initially occur?

The client's sodium and chloride levels will rise.

The client's arterial blood gas results will reflect acidosis.

The client will lose consciousness.

The client will complain of facial numbness and tingling.

Answer and Explanation

The Correct Answer is B

A. The client's sodium and chloride levels will rise: CO₂ retention affects acid-base balance more directly than it affects electrolyte concentrations like sodium or chloride. Changes in these levels may occur in severe or chronic cases, but they are not the initial response.

B. The client's arterial blood gas results will reflect acidosis: When CO₂ accumulates in the blood due to hypoventilation, it forms carbonic acid, lowering blood pH. This results in respiratory acidosis, which is typically the earliest and most direct physiological response to CO₂ retention.

C. The client will lose consciousness: Loss of consciousness may occur if CO₂ levels rise dramatically and go uncorrected. However, this is a late sign of severe respiratory failure, not the initial or most sensitive indicator.

D. The client will complain of facial numbness and tingling: These symptoms are more characteristic of respiratory alkalosis, often due to hyperventilation, not CO₂ retention. In respiratory acidosis, symptoms are more likely to include drowsiness, confusion, or headache.

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Correct Answer is D

Explanation

A. “The client needs immediate intubation and mechanical ventilation.”Intubation may be required in severe respiratory failure, but not all clients with pulmonary embolism need mechanical ventilation. Suggesting intubation without assessment of the client’s respiratory effort or ABGs is premature.

B. "Maybe the client has respiratory distress syndrome."ARDS is can impair oxygenation, but it is not the most likely explanation for persistent low oxygen saturation in PE. PE more commonly causes ventilation-perfusion mismatch due to blocked blood flow.

C. "The client is breathing too slowly and it interferes with oxygenation."Slow breathing could impair ventilation, but in PE, oxygenation is impaired because blood flow to parts of the lung is blocked, not necessarily due to a respiratory rate issue.

D. "The blood clot interferes with perfusion in the lungs."Pulmonary embolism obstructs blood flow in the pulmonary arteries, resulting in areas of the lung being ventilated but not perfused. This causes a ventilation-perfusion mismatch and leads to reduced oxygenation despite supplemental oxygen.

A. "We will do a simple blood test." B. "We will swab you child's nose and send the specimen for testing." C. "We will have to sedate your child and do a CT scan of his chest." D. “There is no specific test for RSV."

Correct Answer is B

Explanation

A. "We will do a simple blood test.A blood test may show signs of infection, such as elevated white blood cells, but it cannot confirm RSV. It is not a specific or reliable method for diagnosing respiratory syncytial virus in infants.

B. "We will swab your child’s nose and send the specimen for testing.Nasopharyngeal swabs are commonly used to detect RSV using antigen detection or polymerase chain reaction (PCR) testing. The procedure is non-invasive, and highly specific for diagnosing RSV.

C. "We will have to sedate your child and do a CT scan of his chest."CT scans are not used to diagnose RSV and carry unnecessary risk, especially with sedation in infants. Imaging is reserved for complicated or atypical cases and does not confirm viral etiology.

D. “There is no specific test for RSV."There are several reliable tests available for detecting RSV, including rapid antigen tests and PCR from nasal secretions. Accurate testing is important for confirming diagnosis and preventing transmission.

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The nurse is caring for a hospitalized client who is retaining carbon dioxide (CO2) because of respiratory disease. The nurse anticipates which physical response will initially occur?

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Naxlex Comprehensive Predictor Exams

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