A nurse is reviewing the arterial blood gas (ABG) results for a patient diagnosed with progressive Chronic Obstructive Pulmonary Disease (COPD). Which ABG results should the nurse expect for a patient with progressive COPD?

pH 7.55, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 24 mEq/L

pH 7.40, PaCO2 40 mm Hg, PaO2 94 mm Hg, HCO3 22 mEq/L

pH 7.30, PaCO2 60 mm Hg, PaO2 70 mm Hg, HCO3 30 mEq/L

pH 7.38, PaCO2 45 mm Hg, PaO2 88 mm Hg, HCO3 26 mEq/L .

Answer and Explanation

The Correct Answer is C

Choice A rationale
A pH of 7.55, PaCO2 of 30 mm Hg, PaO2 of 80 mm Hg, and HCO3 of 24 mEq/L would indicate respiratory alkalosis, which is not typically associated with progressive COPD67.
Choice B rationale
A pH of 7.40, PaCO2 of 40 mm Hg, PaO2 of 94 mm Hg, and HCO3 of 22 mEq/L represent normal ABG values.
Choice C rationale
A pH of 7.30, PaCO2 of 60 mm Hg, PaO2 of 70 mm Hg, and HCO3 of 30 mEq/L are indicative of respiratory acidosis with metabolic compensation, which is commonly seen in patients with progressive COPD67.
Choice D rationale
A pH of 7.38, PaCO2 of 45 mm Hg, PaO2 of 88 mm Hg, and HCO3 of 26 mEq/L would indicate a slight respiratory acidosis, which is not typically associated with progressive COPD67.

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Correct Answer is D

Explanation

Choice A rationale
This response is more threatening than assertive. Threatening disciplinary action does not address the issue in a constructive manner and may create further conflict.
Choice B rationale
This response is more accusatory than assertive. It may make the colleague defensive and does not encourage open communication.
Choice C rationale
This response is more avoidant than assertive. It does not address the issue directly with the colleague and does not promote effective teamwork.
Choice D rationale
This response is assertive. It communicates the nurse’s feelings and needs clearly and respectfully, without blaming or threatening the colleague. It promotes open communication and effective teamwork.

A. Encourage the client to take breaks from oxygen use to prevent tolerance. B. Maintain nasal oxygen at a 1 to 2 liter/minute flow rate. C. Assess cheeks and posterior ears for signs of skin breakdown. D. Teach the client how to safely increase oxygen flow when they deem necessary.

Correct Answer is B

Explanation

Choice A rationale
While it is important to monitor oxygen use to prevent hypoxia and hypercapnia, taking breaks from oxygen use is not typically recommended for clients with COPD. These clients often require supplemental oxygen to maintain adequate oxygen saturation.
Choice B rationale
Maintaining a low flow rate of oxygen is crucial in clients with COPD. These clients are often “CO2 retainers,” and administering a high concentration of oxygen can suppress their respiratory drive, leading to further CO2 retention and respiratory distress.
Choice C rationale
While it is important to assess for signs of skin breakdown in clients receiving oxygen therapy, this is not the priority when administering nasal oxygen to a client with COPD38.
Choice D rationale
Clients should not adjust their oxygen flow rate without medical supervision. Increasing the oxygen flow rate can lead to hyperoxia, which can be harmful, especially in clients with COPD who are CO2 retainers.

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A nurse is reviewing the arterial blood gas (ABG) results for a patient diagnosed with progressive Chronic Obstructive Pulmonary Disease (COPD). Which ABG results should the nurse expect for a patient with progressive COPD?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is working with a colleague who frequently interrupts and dominates during patient care discussions. The nurse wants to address this behavior assertively to ensure effective teamwork. Which response by the nurse demonstrates assertive behavior?

Correct Answer is D

Explanation

A nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD). Which precaution should the nurse prioritize when administering nasal oxygen therapy to the client?

Correct Answer is B

Explanation

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