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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. When asked about your strengths and weaknesses, focus primarily on your strengths. While highlighting strengths is important, interviewers also value self-awareness and the ability to recognize areas for improvement. Providing a well-balanced answer that includes a genuine weakness and how you are working to improve it demonstrates professionalism and a growth mindset.
B. Ask questions about the salary. While salary is an important consideration, bringing it up too early in the interview may give the impression that financial compensation is the primary concern. It is generally best to wait until the employer brings up salary or discuss it once a job offer has been extended.
C. Place your portfolio containing your resume on the interviewer's desk. Offering a resume or portfolio when asked is appropriate, but placing it on the interviewer’s desk without being invited to do so may come across as overly assertive. A more professional approach is to hand over documents when requested or when relevant to the discussion.
D. Ask questions about the position and the facility. Asking thoughtful questions about the role, work environment, team structure, and opportunities for growth shows genuine interest in the position. It also helps the candidate assess whether the job aligns with their professional goals. Engaging in meaningful dialogue makes a positive impression on the interviewer.
Correct Answer is ["A","B","C"]
Explanation
A. Wear a mask when caring for the client: This is an important action to prevent the spread of influenza, which is transmitted via respiratory droplets. Wearing a mask helps protect both the healthcare provider and other patients from potential exposure to the virus, especially in the early stages of the disease when the client is most contagious.
B. Place the client in a private room: This action is recommended to minimize the risk of transmitting the influenza virus to other patients. Isolating the client in a private room can help control the spread of infection, making it a necessary measure in this situation.
C. Encourage the client to increase fluid intake: Adequate hydration is essential for clients with influenza to help alleviate fever and maintain overall health. Increasing fluid intake supports the immune system and helps prevent complications such as dehydration, so encouraging the client to drink more fluids is appropriate.
D. Place the client on contact precautions: While contact precautions are essential for preventing the spread of infections transmitted by direct contact, they are not specifically necessary for influenza, which is primarily airborne and droplet transmitted. Standard precautions, including droplet precautions, are sufficient for managing a client with influenza.
E. Prepare to administer an antibiotic to the client: This action is not appropriate because influenza is a viral infection, and antibiotics are ineffective against viruses. Treatment for influenza typically involves antiviral medications if indicated, supportive care, and symptom management rather than antibiotics. Therefore, this option should not be included in the actions the nurse takes.
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