A patient has the following blood gases: PaCO2 33, pH 7.50, HCO3 23. Which of the following could NOT be the cause of this condition?

Aspirin toxicity

Fever

Anxiety attack

Chronic obstructive pulmonary disease (COPD)

Answer and Explanation

The Correct Answer is D

A. Aspirin Toxicity:
Effect on Blood Gases: Aspirin toxicity can cause respiratory alkalosis due to increased respiratory rate (hyperventilation), leading to a decreased PaCO2 and increased pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values (low PaCO2 and high pH), making it a possible cause.

B. Fever:
Effect on Blood Gases: Fever might cause hyperventilation, resulting in respiratory alkalosis with decreased PaCO2 and increased pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values.

C. Anxiety Attack:
Effect on Blood Gases: Anxiety attacks can lead to hyperventilation and subsequent respiratory alkalosis with low PaCO2 and high pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values.

D. Chronic Obstructive Pulmonary Disease (COPD):
Effect on Blood Gases: COPD typically causes respiratory acidosis due to impaired gas exchange, resulting in elevated PaCO2 and decreased pH.
Relation to Given Blood Gases: COPD wouldn't typically cause the observed blood gas values of low PaCO2 and high pH.

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Correct Answer is C

Explanation

A. Persistently cold feet:
This may be a sign of poor circulation, which is more associated with peripheral vascular disease than neuropathy.

B. Acute pain, unrelieved by rest:
Acute pain is not typically associated with peripheral neuropathy. Neuropathic pain is often chronic and may include sensations like tingling or burning.

C. The presence of a tingling sensation:
This is correct. Tingling sensations, along with numbness and pain, are common symptoms of peripheral neuropathy in diabetes.

D. Pain that does not respond to analgesia:
While neuropathic pain can be challenging to manage, the primary focus is on the characteristic nature of the pain (tingling, burning) rather than its response to analgesics.

A. Liaise with the respiratory therapist and consider high flow oxygen. B. Inform the primary care provider that the patient may have an infection. C. Apply supplementary oxygen by nasal cannula. D. Administer bronchodilators by nebulizer.

Correct Answer is B

Explanation

A. Inform the primary care provider that the patient may have an infection:
Explanation: The presence of an elevated oral temperature and new onset of fine crackles on lung auscultation suggests a potential respiratory infection, which is a significant concern in a patient with sickle cell disease. Notifying the primary care provider allows for further evaluation and appropriate management of the infection.

B. Liaise with the respiratory therapist and consider high-flow oxygen:
Explanation: While oxygenation may be necessary, especially if the patient is experiencing respiratory distress, addressing the potential infection is the priority. Consulting with the respiratory therapist and considering high-flow oxygen can be part of the overall plan based on the primary care provider's recommendations.

C. Apply supplementary oxygen by nasal cannula:
Explanation: Providing oxygen support may be necessary, but it should be done in consultation with the primary care provider, who can guide the appropriate level of oxygen therapy based on the patient's condition.

D. Administer bronchodilators by nebulizer:
Explanation: Bronchodilators are typically used for conditions like asthma or COPD, and their use might not be the primary intervention in the context of a sickle cell crisis with signs of a potential respiratory infection. Addressing the infection takes precedence, and the primary care provider's input is essential in determining the appropriate course of action.

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A patient has the following blood gases: PaCO2 33, pH 7.50, HCO3 23. Which of the following could NOT be the cause of this condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has diabetes for the presence of peripheral neuropathy. The nurse should question the client about what sign or symptom that would suggest the possible development of peripheral neuropathy?

Correct Answer is C

Explanation

A client is being treated on the medical unit for a sickle cell crisis. The nurse's most recent assessment reveals an oral temperature of 100.5°F and a new onset of fine crackles on lung auscultation. What is the nurse's most appropriate action?

Correct Answer is B

Explanation

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