The nurse is caring for a patient receiving a continuous albuterol nebulizer for an acute asthma attack. Which arterial blood gas result would indicate that the treatment has been effective?

ABG Value

Normal Range

pH

7.35- 7.45

PaCO2

35-45 mm Hg

HCO3

22-25 mEq/L

Base excess

-2 to +2

PaO2

80-95 mm Hg

SaO2

>95%

pH 7.39, PaO2 88 mmHg, PaCO2 35 mmHg, HCO3 23 mEq/L

pH 7.52, PaO2 86 mmHg, PaCO2 30 mmHg, HCO3 22 mEq/L

pH 7.35, PaO2 75 mmHg, PaCO2 48 mmHg, HCO3 27 mEq/L

pH 7.30, PaO2 90 mmHg, PaCO2 44 mmHg, HCO3 18 mEq/L

Answer and Explanation

The Correct Answer is A

A. A pH within the normal range, a PaCO2 within the normal range, and an improved PaO2 level suggest effective treatment for an asthma attack, indicating adequate gas exchange and resolution of respiratory distress.

B. A pH of 7.52 and low PaCO2 suggest respiratory alkalosis, which can occur with hyperventilation and may indicate overventilation rather than effective asthma treatment.

C. This result shows elevated PaCO2 and borderline low PaO2, indicating ongoing respiratory acidosis and hypoxia, suggesting the treatment is not yet effective.

D. This ABG result shows low pH, indicating acidosis, and a low bicarbonate level, which may indicate metabolic acidosis rather than effective asthma management.

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Correct Answer is ["3"]

Explanation

To administer the correct dose of clonidine, which is 0.3 mg, the nurse would need to calculate the number of 0.1 mg tablets required. Since each tablet contains 0.1 mg of clonidine, the nurse would need three tablets to make up the total dose of 0.3 mg. Therefore, the nurse should administer three tablets per dose to the patient.

A. Administer antibiotics due to increased risk of infection B. Prevent the drainage by applying a pressure dressing C. Hang intravenous (IV) fluids to replace fluids lost D. Allow fluid to drain from the patient's ear onto gauze and notify provider

Correct Answer is D

Explanation

A. Antibiotics may be necessary if infection is confirmed, but this is not the priority action.

B. Applying a pressure dressing could increase intracranial pressure or worsen the injury.

C. IV fluids can be helpful in managing shock but are not directly related to CSF leakage management.

D. Yellowish fluid from the ear, which creates a "halo" or yellow ring around it on gauze, may indicate cerebrospinal fluid (CSF) leakage. This is a sign of a potential skull fracture and requires prompt provider notification. Allowing the fluid to drain and collecting it can provide necessary information about the injury.

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ABG Value	Normal Range
pH	7.35- 7.45
PaCO2	35-45 mm Hg
HCO3	22-25 mEq/L
Base excess	-2 to +2
PaO2	80-95 mm Hg
SaO2	>95%

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer clonidine 0.3 mg at bedtime to a patient. The amount available is clonidine 0.1 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["3"]

Explanation

The nurse is caring for a trauma patient with suspected brain injury. The nurse notices a yellow stain around fluid dripping from the patient's ear. The nurse's priority intervention will be as follows:

Correct Answer is D

Explanation

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