Mrs. Jamerson, who is in the post anesthesia care unit (PACU) following surgery, is difficult to arouse and demonstrates shallow breathing. The patient does not respond to any stimuli. The nurse assesses the patient and obtains arterial blood gas (ABG) measurements STAT. The ABG shows a pH of 7.10, PaCO2 of 70 mm Hg, and HCO3 of 24 mEq/L. What does this mean?

Respiratory Alkalosis Partially Compensated

Respiratory Acidosis Uncompensated

Metabolic Alkalosis Partially Compensated

Metabolic Acidosis Uncompensated

Answer and Explanation

The Correct Answer is B

Choice A reason: Respiratory Alkalosis Partially Compensated is characterized by an elevated pH over 7.45 and a PaCO2 under 35 mmHg, with a compensatory acidic HCO3 under 22 mEq/L. This does not match the patient's ABG results.

Choice B reason: Respiratory Acidosis Uncompensated is indicated by an acidic pH under 7.35 and an elevated PaCO2 over 45 mmHg, with HCO3 in the normal range of 2226 mEq/L. The patient's ABG results show a low pH and high PaCO2, which aligns with this condition.

Choice C reason: Metabolic Alkalosis Partially Compensated would show a basic pH over 7.45 and a basic HCO3 over 26 mEq/L, with a compensatory acidic PaCO2 over 45 mmHg[^10^]. The patient's ABG values do not support this diagnosis.

Choice D reason: Metabolic Acidosis Uncompensated would present with an acidic pH under 7.35 and an acidic HCO3 under 22 mEq/L, with PaCO2 in the normal range of 3545 mmHg⁸. The patient's normal HCO3 level does not indicate metabolic acidosis.

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Correct Answer is ["A","B","D"]

Explanation

Choice A reason: Blowing the nose gently is advised to prevent nosebleeds, which can be a risk due to thrombocytopenia.

Choice B reason: Lubricating lips with water-soluble ointment can prevent cracking and bleeding, which is important for a patient with thrombocytopenia.

Choice C reason: Using a straightedge razor is not recommended because it can increase the risk of cuts and bleeding. An electric razor would be safer.

Choice D reason: Brushing teeth with a soft toothbrush is recommended to prevent gum bleeding due to the low platelet count associated with thrombocytopenia.

Choice E reason: Limiting fruit consumption is not necessary for thrombocytopenia unless the patient has a specific condition that requires dietary restrictions.

A. Apply heat for 10 minutes every hour. B. Sleep in a side lying position with flexed knees. C. Avoid prolonged sitting. D. Use padded shoe insoles. E. Sleep on a soft matress

Correct Answer is ["A","B","C"]

Explanation

Choice A: Apply heat for 10 minutes every hour
Applying heat can help to relax the muscles and relieve tension, which can reduce pain. Heat therapy increases blood flow, which can aid in healing and reduce stiffness.

Choice B: Sleep in a side lying position with flexed knees
Sleeping in a side-lying position with flexed knees can help to maintain the natural curve of the spine and reduce strain on the back muscles. It's also recommended to use a pillow between the knees for additional support.

Choice C: Avoid prolonged sitting
Prolonged sitting can put pressure on the discs in your lower back and cause or exacerbate pain. It's recommended to take regular breaks to stand up and move around.

Choice D: Use padded shoe insoles
While padded shoe insoles can provide comfort and support for some people, there's no strong evidence to suggest that they can help to prevent or relieve back pain.

Choice E: Sleep on a soft mattress
Contrary to popular belief, a soft mattress may not be the best choice for people with back pain. A mattress that's too soft can cause your back to sink into the mattress, leading to poor sleep posture and discomfort. It's generally recommended to choose a mattress that provides good support and maintains the spine's natural alignment.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is creating a teaching plan for a client who has thrombocytopenia. Which of the following instructions should the nurse include? (Select all that apply.)

Correct Answer is ["A","B","D"]

Explanation

A nurse is educating coworkers on how to minimize back strain and avoid repeated episodes of low back pain. Which of the following strategies should the nurse include? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

A nurse is planning care for a client who has just had spinal surgery. Which of the following actions should the nurse include in the plan of care?

A nurse is monitoring a client who is receiving packed RBCs. The nurse identifies which of the following as an expected finding?

A nurse is assessing a client who has a suspected diagnosis of Guillain-Barre syndrome (GBS). Which of the following questions should the nurse ask the client?

A nurse suspects a client with myasthenia gravis is experiencing a myasthenic crisis. Which of the following interventions should the nurse take?

A nurse is creating a dietary plan for an adult female client who has a hemoglobin level of 9.8 g/dL. Which of the following foods should the nurse recommend?

A nurse is assigned to care for a client diagnosed with autoimmune or idiopathic thrombocytopenic purpura (ITP). When reviewing the client's plan of care prior to caring for the client, the nurse should recognize that the priority concern in caring for the client is to monitor for: