NUR 406 Exam 18
1. The nurse reviews the arterial blood gases of a patient. Which result would indicate the
patient has later-stage COPD?
a. pH 7.32, PaCO2 58 mm Hg, PaO2 60 mm Hg, HCO3 30 mEq/L
b. pH 7.30, PaCO2 45 mm Hg, PaO2 55 mm Hg, HCO3 18 mEq/L
c. pH 7.40, PaCO2 40 mm Hg, PaO2 70 mm Hg, HCO3 25 mEq/L
d. pH 7.52, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 35 mEq/L
Answer
a. pH 7.32,
PaCO2 58 mm Hg, PaO2 60 mm Hg, HCO3 30 mEq/L
2. A patient's ABG results include
pH 7.31
PaCO2 50 mm Hg PaO2 51 mm Hg HCO3 24 mEq/L
Oxygen is administered at 2 L/min, and the patient is placed in high-Fowler's position. An hour
later the ABGs are repeated with a results of
pH 7.36
PaCO2 40 mm Hg PaO2 60 mm Hg HCO3 24 mEq/L
What is most important for the nurse to do?
a. Increase the oxygen flow rate to 4 L/min
b. Document the findings in the patient's record
c. Reposition the patient in a semi-Fowler's position
d. Prepare the patient for endotracheal intubation and mechanical ventilation-
Answer
a. Increase the oxygen flow rate to 4 L/min
3. Which patient is at highest risk for hypoxemic respiratory failure?
a. A patient who has respiratory muscle paralysis
b. A patient who has fractured ribs and a flail chest
c. A patient who has a massive pulmonary embolism
,d. A patient who has slow breathing from a drug overdose
Answer
c. A patient who has a massive pulmonary embolism
4. A patient's ABG results include pH 7.32
PaCO3 50 mmHg
PaO2 51 mmHg
HCO3 24 mEq/L
Oxygen is administered at 2 L/min, and the patient is placed in high-fowler's position. An hour
later, the ABGs are repeated with results of
pH 7.36
PaCO2 40 mmHg
PaO2 60 mmHg
HCO3 24 mEq/L
What is most important for the nurse to do?
a. increase the oxygen flow rate to 4 L/min
b. document the findings in the patient's record
c. reposition the patient in a semi-Fowler's position
d. prepare the patient for endotracheal intubation and mechanical ventilation-
Answer
a. increase the oxygen flow rate to 4 L/min
5. When assessing a patient with sepsis, which finding would alert the nurse to the onset of
acute respiratory distress syndrome (ARDS)?
a. SpO2 of 80%
b. use of accessory muscles of respiration
c. fine, scattered crackles on auscultation of the chest
d. ABGs of oH 7.33, PaCO2 49 mmHg, PaO2 80 mmHg
Answer
c. fine, scattered crackles on auscultation of the chest
6. A patient with severe chronic lung disease is hospitalized with respiratory distress. Which
finding would suggest to the nurse that the patient has devel- oped rapid decompensation?
a. an SpO2 of 86%
b. a blood pH of 7.33
, c. agitation of confusion
d. PaCO2 increases from 48 to 55 mmHg
Answer
c. agitation of confusion
7. A patient with a history of alcoholism is admitted to the ICU with hemor- rhage from
esophageal varices. Admission VS are BP 84/58 mmHg, HR 105, RR 32. The nurse recognizes
the onset of systemic inflammatory response syndrome (SIRS) upon finding
a. pulmonary edema
b. cardiac dysrhythmias
c. absent bowel sounds
d. decreasing blood pressure
Answer
a. pulmonary edema
8. A patient admitted to the hospital from a long-term care facility appears to be in the late
stage of shock with systemic inflammatory response syndrome (SIRS). Which order
implemented by the nurse has the highest priority?
a. insert an indwelling urinary catheter
b. insert two large-bore intravenous catheters
c. administer 0.9% normal saline at 100 mL/hr
d. administer 100% oxygen by non-rebreather mask
Answer
b. insert two large-bore intravenous catheters
9. Isoniazid
Answer
an antitubercular given to patient's with TB infection
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