The nurse is reading the arterial blood gas results of a patient admitted for sepsis. Which of the following would the nurse expect for a patient in metabolic acidosis?

pH 7.25. CO2 40. HCO3-16

pH 7.5, CO2 35, HCO3-30

pH 7.5, CO2 30 HCO3- 22

pH 7.25, CO2 55. HCO3. 25

Answer and Explanation

The Correct Answer is A

A) pH 7.25, CO2 40, HCO3- 16:
In metabolic acidosis, the pH is decreased indicating acidemia. The bicarbonate level is low which is a hallmark of metabolic acidosis. The CO2 level of 40 is within the normal range suggesting that the body is not compensating for the acidosis through respiratory compensation yet. In metabolic acidosis, the body will often try to compensate by increasing respiratory rate to blow off CO2, but this takes time.

B) pH 7.5, CO2 35, HCO3- 30:
In metabolic alkalosis, the pH is increased above 7.45, and the bicarbonate level (HCO3-) is elevated both of which are seen here. The CO2 level of 35 is within normal limits, and while respiratory compensation could increase CO2 in response to metabolic alkalosis,

C) pH 7.5, CO2 30, HCO3- 22:
The pH is increased above 7.45, and the bicarbonate level is within the normal range. The CO2 level of 30 is low, which is typical in respiratory alkalosis, where the body compensates for the increased pH by blowing off CO2.

D) pH 7.25, CO2 55, HCO3- 25:
The pH is low, but the bicarbonate level is normal. The CO2 level is elevated, which is indicative of hypoventilation or inadequate respiratory compensation, commonly seen in respiratory acidosis, where the lungs cannot excrete CO2 effectively

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Correct Answer is ["8"]

Explanation

Given:

Total volume to infuse: 150 mL

Infusion time: 3 hours

Drop factor of tubing: 10 gtt/mL

To find:

Drip rate (gtt/min)

Step 1: Convert infusion time to minutes

3 hours x 60 minutes/hour = 180 minutes

Step 2: Calculate the total number of drops

Total drops = Total volume x Drop factor

Total drops = 150 mL x 10 gtt/mL = 1500 gtt

Step 3: Calculate the drip rate

Drip rate = Total drops / Infusion time in minutes

Drip rate = 1500 gtt / 180 minutes = 8.33 gtt/min

Step 4: Round to the nearest whole number

Since the question asks for the drip rate rounded to the nearest whole number, we round 8.33 to 8 gtt/min.

A. Western Blot test B. Initiation of broad-spectrum antibiotics C. Initiation of Isoniazid and Rifampin D. Antiretroviral therapy.

Correct Answer is B

Explanation

A) "Western Blot test":
. The Western Blot test is typically used to confirm HIV infection after a positive enzyme-linked immunosorbent assay (ELISA). This test is not relevant for diagnosing pneumonia, which is the most likely cause of this patient's symptoms. The patient's presentation — including dyspnea on exertion, cough with green sputum, fever, fatigue, and bilateral consolidation on the chest X-ray — points to a respiratory infection (likely pneumonia) rather than an HIV-related issue.

B) "Initiation of broad-spectrum antibiotics":
. The patient's symptoms, including dyspnea, cough with green sputum, fever, fatigue, and bilateral consolidation on chest X-ray, strongly suggest community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP). In either case, broad-spectrum antibiotics are indicated to cover a wide range of potential bacterial pathogens, especially in older adults or those with comorbidities who may be at risk for more severe infections. Immediate treatment with antibiotics is necessary to prevent complications such as respiratory failure or sepsis. Once cultures and sensitivities are obtained, the antibiotics may be adjusted based on the specific pathogen.

C) "Initiation of Isoniazid and Rifampin":
. Isoniazid and Rifampin are used to treat tuberculosis (TB), but this patient’s symptoms do not indicate TB. The patient is experiencing acute respiratory symptoms, including fever, cough with sputum production, and consolidation on chest X-ray, which are more indicative of pneumonia than of tuberculosis. Although TB could present similarly, additional testing such as a TB skin test (TST) or sputum culture for acid-fast bacilli (AFB) would be necessary before initiating antitubercular therapy. The priority intervention here is antibiotic treatment for bacterial pneumonia.

D) "Antiretroviral therapy":
. Antiretroviral therapy (ART) is used to treat HIV, but there is no indication that this patient has HIV. The symptoms presented — dyspnea, productive cough, fever, and bilateral consolidation on chest X-ray — are more consistent with an acute bacterial infection such as pneumonia rather than an HIV-related complication. ART would only be appropriate if the patient were known to have HIV and developed an opportunistic infection; however, this patient's presentation suggests a primary respiratory infection, not an HIV-related issue.

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The nurse is reading the arterial blood gas results of a patient admitted for sepsis. Which of the following would the nurse expect for a patient in metabolic acidosis?

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["8"]

Explanation

An older adult client presents with dyspnea on exertion, cough with green sputum, fever, and fatigue. The nurse notes thick rhonchi/coarse crackles upon lung auscultation and the patient's chest X-ray shows bilateral consolidation. The nurse anticipates which of the following interventions?

Correct Answer is B

Explanation

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