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
While it’s true that appetite and sense of smell are closely linked, the return of appetite does not necessarily mean the return of the sense of smell, especially after a total laryngectomy.
Choice B rationale
The body does not develop an ability to smell through the stoma. The sense of smell is primarily mediated by the olfactory nerve (Cranial Nerve I), which is located in the upper part of the nasal cavity.
Choice C rationale
The sense of smell does not typically return after several months following a total laryngectomy. This is because the surgery involves removal of the larynx and separation of the airway from the mouth, nose and throat.
Choice D rationale
Breathing through a stoma after a total laryngectomy does alter the sense of smell. This is because the nose and mouth are bypassed during breathing, and these are the primary routes for smell.

A. Require nurses to demonstrate competency by passing a medication administration test. B. Review the circumstances leading up to each medication error. C. Develop a quality improvement program for nurses involved in medication errors. D. Conduct an in-service training on medication administration for all nurses.

Correct Answer is B

Explanation

Choice A rationale
While ensuring that nurses demonstrate competency by passing a medication administration test is important, it is not the first step in developing a program to decrease medication administration errors. This strategy focuses on the individual skills of the nurses, but does not address the systemic issues that may have contributed to the errors.
Choice B rationale
Reviewing the circumstances leading up to each medication error is the first step in understanding why the errors occurred. This process allows the committee to identify patterns and common factors that contribute to errors. It is a crucial step in the development of effective strategies to prevent future errors.
Choice C rationale
Developing a quality improvement program for nurses involved in medication errors is a strategy that could be implemented after understanding the root causes of the errors. This approach ensures that the program addresses the specific issues that led to the errors.
Choice D rationale
Conducting an in-service training on medication administration for all nurses is a valuable strategy for preventing medication errors. However, it should be based on the findings from the review of the circumstances leading up to each error. Therefore, it is not the first strategy to consider.

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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 caring for a patient who reports experiencing an alteration in sense of smell following surgery for a total laryngectomy. The nurse should address the patient’s concern through which of the following responses?

Correct Answer is D

Explanation

A nurse is part of a Continuous Quality Improvement (CQI) committee tasked with developing a program to decrease medication administration errors following a sentinel event. Which strategy should the committee consider implementing first?

Correct Answer is B

Explanation

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