A client receiving mechanical ventilation has a pH of 7.26, PaCO2 of 68 mm Hg, and a PaO2 of 92 mm Hg. Which intervention should the nurse implement?Reference Range:
Arterial Blood Gas (ABG)
pH [Adult/child: 7.35 to 7.45]
PaCO2 [Adult/child: 35 to 45 mm Hg)
HCO- [Adult/child: 21 to 28 mEq/L (21 to 28 mmol/L)] PaO2 [Adult/child: 80 to 100 mm Hg)

Increase rate of ventilation.

Decrease expiratory flow time.

Increase ventilator tidal volume.

Decrease expiratory pressure.

Answer and Explanation

The Correct Answer is A

Rationale

A. The client's pH is low (acidotic), and the PaCO2 is high (respiratory acidosis). Increasing the rate of ventilation (respiratory rate) can help to decrease PaCO2 by increasing alveolar ventilation, thereby helping to correct respiratory acidosis.

B. Expiratory flow time affects the time available for exhalation. While this may affect the overall mechanics of ventilation, it is not directly targeting the primary issue of elevated PaCO2 and acidosis.

C. Increasing tidal volume increases the volume of air delivered with each breath. This can improve ventilation efficiency but may not address the underlying problem of elevated PaCO2 unless it leads to increased minute ventilation.

D. Expiratory pressure is related to positive end-expiratory pressure (PEEP), which helps maintain alveolar recruitment and improve oxygenation. Decreasing expiratory pressure may not directly address the elevated PaCO2 and acidosis.

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Correct Answer is B

Explanation

Rationale

A. This statement is partially true as most sexually transmitted infections (STIs), including syphilis, are primarily transmitted through sexual intercourse. However, not all STIs are exclusively transmitted through sexual contact.

B. Syphilis is caused by the bacterium Treponema pallidum and can be transmitted through direct contact with a syphilitic sore (chancre) during vaginal, anal, or oral sex. If a person has syphilis and engages in unprotected sex with a partner who is not treated, they can potentially contract or transmit the infection again, leading to reinfection.

C. While contraceptives such as condoms provide protection against unintended pregnancy and some STIs, including syphilis, they do not offer complete protection against all STIs. Condoms are effective in reducing the risk of transmission of syphilis when used consistently and correctly, but they are not 100% protective.

D. Using safe sex practices, such as consistent and correct use of condoms, reduces the risk of acquiring or transmitting STIs, including syphilis. Safe sex practices also include mutual monogamy and regular testing for STIs, especially for those who have multiple sexual partners or engage in high-risk sexual behaviors.

A. Finish the procedure. B. Close the room door. C. Call for an assistant. D. Respond to the code.

Correct Answer is D

Explanation

Rationale

A. Continuing with the tracheostomy care procedure while a code blue is ongoing for another client is not appropriate. A code blue takes precedence as it indicates a life-threatening emergency requiring immediate response.

B. Closing the room door is not a priority action during a code blue. The immediate focus should be on responding to the emergency and providing assistance as needed.

C. If additional help is needed to assist with the tracheostomy care procedure, calling for an assistant could be appropriate under normal circumstances. However, during a code blue, the primary responsibility is to respond to the emergency immediately.

D. A code blue indicates a cardiac or respiratory arrest, which requires immediate intervention. As a nurse, responding to the code blue involves providing assistance with cardiopulmonary resuscitation (CPR), fetching emergency equipment, and supporting the healthcare team in resuscitative efforts.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with the sexually transmitted infection (STI) syphilis. The client reports having unprotected sex. Which response should the nurse provide?

Correct Answer is B

Explanation

The nurse is performing tracheostomy care for a client when a code blue is called for another client on the unit who experiences a cardiopulmonary arrest. Which action should the nurse take?

Correct Answer is D

Explanation

In caring for a client following a head injury, the nurse plans to assess for rhinorrhea so that a sample can be tested for the presence of cerebrospinal fluid (CSF). At which location should the nurse observe for this finding? (Click the chosen location. To change, click on the new location.)

The nurse observes that a client with ascites is dyspneic. Which action should the nurse implement first?

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