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 A

Explanation

A. Elevating the head of the bed, loosening clothing, and checking for urinary catheter obstruction are key steps to lower blood pressure and relieve triggers of autonomic dysreflexia, a potentially life-threatening condition.

B. A cool compress may provide comfort but does not directly address the primary triggers or symptoms of autonomic dysreflexia.

C. Semi-Fowler's position is insufficient compared to a full 90-degree sitting position, which helps reduce blood pressure.

D. IV access and oxygen may be required if symptoms do not resolve, but immediate actions focus on relieving the cause of dysreflexia.

A. Neurogenic shock B. Brain herniation C. Spinal shock D. Autonomic dysreflexia

Correct Answer is A

Explanation

A. Neurogenic shock occurs in spinal cord injuries above T6 and is characterized by hypotension, bradycardia, and loss of sympathetic tone below the level of injury. This condition results from disruption of autonomic pathways.

B. Brain herniation typically involves increased intracranial pressure and different neurological symptoms.

C. Spinal shock involves temporary loss of reflexes and sensation but does not specifically cause bradycardia or hypotension.

D. Autonomic dysreflexia involves sudden high blood pressure and is usually triggered by noxious stimuli, occurring after the acute phase of SCI.

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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

The nurse suspects autonomic dysreflexia in the patient with a spinal cord injury at the level of C-7. After checking vital signs what are the priority nursing interventions?

Correct Answer is A

Explanation

The nurse is caring for a patient immediately after a spinal cord injury between T7-T8 vertebrae. The patient displays the following symptoms: absent reflexes, flaccidity, loss of sensation below the level of injury, bradycardia, and hypotension. These are signs of which condition?

Correct Answer is A

Explanation

Which statement made by a patient who is diagnosed with human immunodeficiency virus (HIV) and is prescribed three antiretroviral medications, indicates the need for further teaching about the medication combination?

The nurse suspects autonomic dysreflexia in the patient with a spinal cord injury at the level of C-7. After checking vital signs what are the priority nursing interventions?

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A 24-year-old patient who is an intravenous drug user asks the nurse about preventing acquired immunodeficiency syndrome (AIDS). The nurse informs the patient that the risk of developing the human immunodeficiency virus (HIV) infection from drug use can be reduced by:

The nurse is performing the morning assessment on a patient. The patient suddenly screams loudly and begins to have a generalized tonic/clonic type seizure. What is the priority nursing intervention?