Exhibits
A nurse is reviewing the medical record of a client who has COPD. The nurse should notify the provider about which of the following findings? (Click on the exhibit tabs for additional information about the client. There are three tabs that contain separate categories of data.)
SpO2
PH
Respiratory rate
Temperature
The Correct Answer is B
Rationale:
A. SpO₂: Although 88% is low for the general population, it is often an acceptable baseline for clients with COPD. Their oxygen saturation targets are typically between 88–92% to avoid suppressing respiratory drive, so this value may not require immediate provider notification.
B. pH: A pH of 7.22 indicates respiratory acidosis, which is a serious and potentially life-threatening complication of COPD. This level of acidosis shows that the client’s ventilation is inadequate, and immediate intervention is needed. This is the most critical finding that requires provider notification.
C. Respiratory rate: A rate of 22 breaths/min is slightly elevated but not critical. It may be compensatory and expected in a COPD patient who is hypoxic or retaining CO₂. By itself, it doesn't warrant urgent notification unless it worsens.
D. Temperature: A temperature of 37.2°C (99°F) is within the normal range and does not indicate infection or acute illness. It is not a finding that necessitates notifying the provider at this point.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. "The proxy should manage legal issues for the client." A health care proxy designated through a durable power of attorney for health care is authorized to make medical not legal decisions. Legal affairs typically require a separate legal power of attorney.
B. "The proxy can make treatment decisions if the client is under anesthesia." The health care proxy is activated when the client is unable to make decisions for themselves, including temporary incapacity such as being under general anesthesia. This ensures continuity of care and respects the client’s wishes.
C. "The proxy should make health care decisions for the client regardless of the client's ability to do so." The proxy only steps in when the client is deemed incapacitated. If the client is alert and competent, they retain the right to make all decisions about their care.
D. "The proxy can make financial decisions if the need arises." A health care proxy does not have authority over financial matters. Financial decisions are managed through a separate durable power of attorney for finances, not through a health care DPAHC.
Correct Answer is D
Explanation
Rationale:
A. Diplopia: Double vision (diplopia) is not a typical symptom of systemic lupus erythematosus (SLE). It is more commonly associated with neurologic or ocular conditions like multiple sclerosis or cranial nerve palsy.
B. Esophagitis: Esophagitis is not a hallmark manifestation of SLE. While SLE can affect any organ system, gastrointestinal involvement is less common and typically secondary to medications rather than the disease itself.
C. Bradykinesia: Bradykinesia is characterized by slowed movements and is commonly associated with Parkinson’s disease, not with SLE.
D. Fever: Fever is a common finding during acute exacerbations of SLE. It results from systemic inflammation and immune activation, which are characteristic of disease flare-ups.
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