A nurse is reviewing arterial blood gas results for a client diagnosed with chronic obstructive pulmonary disease (COPD). The nurse should expect which abnormal finding?

Increased arterial oxygen

Increased pH

Increased carbon dioxide

Decreased alveolar function

Answer and Explanation

The Correct Answer is C

A. Increased arterial oxygen: Clients with COPD typically experience chronic hypoxemia due to alveolar destruction, airway inflammation, and mucus production, which impair gas exchange. Rather than increased oxygen levels, they often have a decreased PaO₂, requiring supplemental oxygen therapy. However, excessive oxygen administration can suppress their respiratory drive, worsening CO₂ retention.
B. Increased pH: COPD is associated with respiratory acidosis due to chronic CO₂ retention from inadequate alveolar ventilation. While the kidneys compensate by increasing bicarbonate retention, the pH usually remains low or near normal in chronic cases rather than becoming elevated. A higher pH would indicate alkalosis, which is not typical in COPD unless there is an additional metabolic disturbance.
C. Increased carbon dioxide: COPD causes airway obstruction and reduced alveolar ventilation, leading to CO₂ retention (hypercapnia). As CO₂ accumulates in the blood, it lowers the pH, resulting in respiratory acidosis. Chronic hypercapnia is a hallmark of advanced COPD, and in response, the kidneys retain bicarbonate to partially compensate, stabilizing the pH over time but leaving PaCO₂ elevated.
D. Decreased alveolar function: While COPD does lead to progressive alveolar damage and reduced gas exchange, this is a structural and functional change rather than a specific abnormality seen in arterial blood gases. The primary ABG finding in COPD is hypercapnia, which reflects inadequate ventilation and CO₂ retention rather than just decreased alveolar function alone.

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Correct Answer is B

Explanation

A. Poorly coordinated care and nosocomial infections are examples of errors: While poorly coordinated care can lead to adverse events, nosocomial infections are typically classified as healthcare-associated infections rather than errors. Errors generally refer to mistakes made in clinical practice that can lead to harm, whereas nosocomial infections are outcomes that arise from the healthcare environment.
B. As many as 90% of medication errors are preventable: This statement is true and highlights the significant opportunity for improvement in patient safety. Recognizing that a large percentage of medication errors can be prevented underscores the importance of implementing safety protocols, effective communication, and education to reduce the likelihood of errors occurring in clinical practice.
C. Errors of execution are usually intentional and occur because of time or resource constraints: This statement is misleading, as errors of execution typically refer to mistakes made during the performance of a task rather than intentional actions. These errors often occur due to lack of knowledge, skill, or attention rather than being intentional, and they are not solely attributed to time or resource constraints.
D. Medication errors are adverse events: While medication errors can lead to adverse events, not all medication errors result in harm. An adverse event is defined as an injury caused by medical management rather than the underlying condition of the patient, so this statement is not entirely accurate. Medication errors can be classified as near misses or adverse events, depending on whether they resulted in harm to the patient.

A. Vanilla ice cream B. Chicken noodle soup C. Hot herbal tea D. Fruit-flavored popsicles

Correct Answer is D

Explanation

A. Vanilla ice cream: While ice cream may be soothing for a sore throat, it is not the most nutritious option for a client with bacterial pharyngitis. Although it provides calories and can help with throat discomfort, it lacks essential nutrients that support recovery and may not help with hydration, which is critical during illness.
B. Chicken noodle soup: This option can be beneficial due to its warm temperature and potential nutritional value, including protein and hydration. However, the heat of the soup may irritate a sore throat further, especially if it is too hot. It can be a good option, but care should be taken to ensure it is at a comfortable temperature for the client.
C. Hot herbal tea: While herbal tea can provide hydration and soothing effects, it may also irritate a sore throat if served too hot. The temperature of the tea is a consideration, as consuming very hot liquids can exacerbate throat discomfort. Therefore, while it can be helpful, it may not be the best option for promoting comfort.
D. Fruit-flavored popsicles: This is the most recommended option for promoting nutrition during treatment for bacterial pharyngitis. Popsicles are cold, which can soothe a sore throat and reduce inflammation. They are also hydrating, easy to swallow, and can provide some calories, making them a good choice for maintaining nutrition and comfort during recovery. This option balances soothing relief with hydration and nutrition effectively.

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A nurse is reviewing arterial blood gas results for a client diagnosed with chronic obstructive pulmonary disease (COPD). The nurse should expect which abnormal finding?

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