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 A

Explanation

A. Incentive spirometry: This is the most effective independent nursing measure to prevent atelectasis. Incentive spirometry encourages deep breathing and lung expansion, which helps to keep the alveoli open and reduces the risk of collapse. It is particularly beneficial for clients at risk for atelectasis, such as those who have had surgery, are immobile, or have respiratory issues. Regular use of the incentive spirometer promotes optimal lung function and helps prevent the development of atelectasis.
B. Increase oral fluid intake: While maintaining adequate hydration is important for overall health and can help thin secretions, it is not as directly effective in preventing atelectasis as incentive spirometry. Increased fluid intake alone does not promote deep breathing or lung expansion, which are critical in preventing airway collapse.
C. Ambulation: Although ambulation is an important intervention for promoting overall mobility and respiratory function, it may not be as practical for all clients, especially those who are unable to move independently. While getting the client up and moving can help prevent atelectasis, the most immediate and effective measure remains the use of incentive spirometry, which can be performed regardless of the client’s mobility status.
D. Oxygen therapy: While oxygen therapy can help improve oxygenation in clients with respiratory issues, it does not directly prevent atelectasis. Providing supplemental oxygen does not address the need for lung expansion and deep breathing, which are essential in maintaining alveolar patency. Therefore, oxygen therapy should not be prioritized as the primary independent measure to prevent atelectasis.

A. Respiratory rate B. Irritability C. Drooling D. Fever E. Immunization status

Correct Answer is {"A":{"answers":"A,B,C"},"B":{"answers":"A,B,C"},"C":{"answers":"B,C"},"D":{"answers":"A,B"},"E":{"answers":"B"}}

Explanation

Respiratory Rate: LTB, Epiglottitis, Foreign Body Aspiration. An increased respiratory rate (tachypnea) is common in both conditions due to airway obstruction and respiratory distress. In epiglottitis, inflammation and swelling of the epiglottis severely restrict airflow, leading to tachypnea. Similarly, foreign body aspiration can cause partial obstruction, increasing respiratory effort and rate. Increased respiratory rate is a significant finding in LTB due to airway narrowing and respiratory distress. The body compensates for the partial airway obstruction by increasing ventilation. However, tachypnea in LTB is usually not as severe as in epiglottitis or foreign body aspiration, where airway obstruction is more critical.
Irritability: LTB, Epiglottitis, Foreign Body Aspiration. Irritability is a common symptom in all three conditions due to hypoxia and respiratory distress. In LTB (croup), inflammation leads to airway narrowing, causing discomfort and restlessness. In epiglottitis, the rapid onset of airway swelling results in agitation. Foreign body aspiration also causes significant distress due to the sudden obstruction of airflow.
Drooling: Epiglottitis, Foreign Body Aspiration. Drooling is characteristic of epiglottitis because the client cannot swallow due to severe throat pain and airway swelling. It is also seen in foreign body aspiration when an object is lodged in the airway or esophagus, making swallowing difficult. Drooling is not a typical feature of LTB, where coughing and stridor are more prominent.
Fever: LTB, Epiglottitis. Both LTB and epiglottitis are caused by infections and present with fever. In LTB, viral infections like parainfluenza commonly cause a low-to-moderate fever. Epiglottitis, often caused by bacterial infections such as Haemophilus influenzae type B (Hib), typically presents with a high fever, as seen in this case. Foreign body aspiration is not associated with fever unless secondary infection develops.
Immunization Status: Epiglottitis. Epiglottitis is strongly linked to Haemophilus influenzae type B (Hib), a bacteria preventable by routine childhood vaccination. In unvaccinated individuals or those with incomplete immunization, epiglottitis is more likely to occur. Immunization status does not directly correlate with LTB (which is viral) or foreign body aspiration.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client at risk for atelectasis. Which independent nursing measure should the nurse prioritize to prevent atelectasis development?

Correct Answer is A

Explanation

Correct Answer is {"A":{"answers":"A,B,C"},"B":{"answers":"A,B,C"},"C":{"answers":"B,C"},"D":{"answers":"A,B"},"E":{"answers":"B"}}

Explanation

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