A client has been placed on a mechanical ventilator. The PCP has ordered the ventilator to be set at a respiratory rate of 28 breaths /min. The nurse questions the order, citing concerns about which acid-base problem?

Base deficit (HCO3): Acidosis

Acid excess (CO2): Acidosis

Base excess (HCO3): Alkalosis

Acid deficit (CO2): Alkalosis

Answer and Explanation

The Correct Answer is B

A. Base deficit (HCO3): Acidosis: A base deficit indicates metabolic acidosis, but respiratory acidosis is more likely with the high rate of ventilation.

B. Acid excess (CO2): Acidosis: This is the correct answer. A high respiratory rate can lead to hyperventilation, decreasing CO2 levels and causing respiratory alkalosis, which may be a concern with an elevated rate.

C. Base excess (HCO3): Alkalosis: This would indicate metabolic alkalosis, but it is not as related to ventilator settings.

D. Acid deficit (CO2): Alkalosis: If the CO2 level is too low due to hyperventilation, this can lead to alkalosis, which the nurse is questioning here.

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Correct Answer is D

Explanation

A. Amiodarone is an antiarrhythmic used to treat ventricular arrhythmias like monomorphic VT, but it is not the first-line treatment for a pulseless patient. Defibrillation should be performed immediately, and amiodarone can be administered after defibrillation if the rhythm persists.

B. CPR is essential for maintaining circulation in a pulseless patient, but defibrillation should be the first priority for monomorphic VT. CPR should be continued if defibrillation is not immediately available, but the most effective intervention is defibrillation to attempt to restore normal rhythm.

C. Cardioversion is used for stable, regular arrhythmias, but for a pulseless client in monomorphic VT, defibrillation is the appropriate first intervention. Cardioversion is typically used when the patient is conscious or stable and is not a priority for pulseless VT.

D. For a pulseless client with monomorphic ventricular tachycardia, defibrillation is the priority intervention. Defibrillation delivers an electric shock to the heart, which may terminate the abnormal rhythm and allow the heart to return to normal sinus rhythm. This is the most effective and immediate treatment for a pulseless client in ventricular tachycardia.

A. "Testicular self-exam will be important on the remaining testis." B. "I will investigate sperm banking before the operation." C. "I can still function sexually without one of my testes." D. "There should be no effect on my ability to reproduce."

Correct Answer is D

Explanation

A. Testicular self-exam remains important for the remaining testis.

B. Sperm banking is a reasonable consideration.

C. Sexual function is usually maintained with one testis.

D. This statement is incorrect; fertility may be affected, hence sperm banking consideration.

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A client has been placed on a mechanical ventilator. The PCP has ordered the ventilator to be set at a respiratory rate of 28 breaths /min. The nurse questions the order, citing concerns about which acid-base problem?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What would be the priority intervention for the care of the client who is pulseless and has the following rhythm on the monitor?

Correct Answer is D

Explanation

The nurse is providing preoperative education to a client prior to having an orchiectomy for testicular cancer. What statement by the client indicates the need to review the information?

Correct Answer is D

Explanation

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