The nurse is caring for a patient who is dyspneic with accessory muscle use, respiratory rate 24 breaths/minute, pulse oximetry 88% on room air, and speaking in phrases. When choosing an oxygen delivery system, which guideline is the most appropriate?

Always use a low flow device such as a nasal cannula or simple face mask.

Correct the PaO2 to a normal level as quickly as possible using mechanical ventilation.

Use continuous positive airway pressure (CPAP) to maintain PaCO2 greater than 50 mmHg.

Increase the PaO2 to an acceptable level at the lowest oxygen concentration possible.

Answer and Explanation

The Correct Answer is D

Choice A reason: Always using a low flow device such as a nasal cannula or simple face mask is not necessarily appropriate for all patients. The choice of device should be based on the patient's oxygen needs and clinical status.

Choice B reason: Correcting the PaO2 to a normal level as quickly as possible using mechanical ventilation is not appropriate in most cases. Rapid correction of oxygen levels can lead to complications such as oxygen toxicity. Mechanical ventilation is used in severe cases but is not the first line of treatment for most patients.

Choice C reason: Using continuous positive airway pressure (CPAP) to maintain PaCO2 greater than 50 mmHg is incorrect. CPAP is used to maintain open airways and improve oxygenation but is not used to target specific PaCO2 levels.

Choice D reason: Increasing the PaO2 to an acceptable level at the lowest oxygen concentration possible is the most appropriate guideline. This approach aims to correct hypoxemia without causing oxygen toxicity. The goal is to achieve adequate oxygenation while minimizing the risk of adverse effects from high oxygen concentrations.

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Correct Answer is ["C","E"]

Explanation

Choice A reason: Taking iron with dairy products to enhance absorption is incorrect. Calcium in dairy products can interfere with the absorption of iron. It is recommended to take iron supplements with water or vitamin C-rich foods to enhance absorption.

Choice B reason: Always taking iron supplements with meals is not necessary and can reduce absorption. Iron is best absorbed on an empty stomach, although taking it with food can help reduce gastrointestinal side effects. The timing should be individualized based on the patient's tolerance.

Choice C reason: Iron will cause the stools to darken in color, which is a common and harmless side effect of iron supplements. Patients should be informed about this to prevent unnecessary concern.

Choice D reason: Limiting foods high in fiber due to the risk of diarrhea is not necessary. High-fiber foods are generally beneficial for overall health and can help prevent constipation, which is a more common side effect of iron supplements.

Choice E reason: Including vitamin C-rich foods or drinks with your iron supplement is recommended. Vitamin C enhances the absorption of non-heme iron from supplements and plant-based sources, improving the efficacy of the treatment.

A. pH 7.48, PaCO2 30, HCO3 24 B. pH 7.41, PaCO2 45, HCO3 29 C. pH 7.31, PaCO2 34, HCO3 18 D. pH 7.25, PaCO2 59, HCO3 30

Correct Answer is A

Explanation

Choice A reason: The lab results pH 7.48, PaCO2 30, HCO3 24 indicate respiratory alkalosis. Hyperventilation leads to excessive loss of carbon dioxide (PaCO2), resulting in an increase in pH (alkaline). This is consistent with pulmonary edema and hyperventilation due to heart failure.

Choice B reason: The lab results pH 7.41, PaCO2 45, HCO3 29 indicate a normal pH with compensated metabolic alkalosis. This is not consistent with hyperventilation in pulmonary edema.

Choice C reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis with partial compensation. This is not typical for a patient with hyperventilation and pulmonary edema.

Choice D reason: The lab results pH 7.25, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This would be consistent with hypoventilation rather than hyperventilation.

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The nurse is caring for a patient who is dyspneic with accessory muscle use, respiratory rate 24 breaths/minute, pulse oximetry 88% on room air, and speaking in phrases. When choosing an oxygen delivery system, which guideline is the most appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing discharge education to a patient with iron deficiency anemia. The patient has been prescribed to take an oral iron supplement. What will the nurse include in the teaching for this patient? (Select All That Apply)

Correct Answer is ["C","E"]

Explanation

The nurse is admitting a patient with pulmonary edema resulting from heart failure. Upon assessment, the nurse notes that the patient is hyperventilating. What lab results will the nurse expect to see?

Correct Answer is A

Explanation

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