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    Exam Review

    1. A nurse is reviewing the laboratory values of a client who has respiratory acidosis. Which of the following findings should the nurse expect?
      A)PaCO2 50 mm Hg
      B)HCO3-30 mEq/L
      C)pH 7.45
      D)Potassium 3.3 mEq/L
    2. A nurse is caring for a female client in the emergency department who reports shortness of breath and pain in the lung area. She states that she started taking birth control pills 3 weeks ago and that she smokes. Her heart rate is 110/min, respiratory rate 40/min, and blood pressure 140/80 mm Hg. Her arterial blood gases are pH 7.50, PaCO2 29 mm Hg, PaO2 60 mm Hg, HCO3 20 mEq/L, and SaO2 86%. Which of the following is the priority nursing intervention?
      A)Prepare to administer a sedative.
      B)Administer oxygen via face mask.
      C)Prepare for mechanical ventilation.
      D)Assess for indications of pulmonary embolism.
    3. A nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)(SATA)
      A)Hypotension
      B)Severe dyspnea
      C)Decreased level of consciousness
      D)Nausea
      E)Headache
    4. A nurse is caring for a client who has a disposable three-chamber chest tube in place. Which of the following findings should indicate to the nurse that the client is experiencing a complication?
      A)Continuous bubbling in the water-seal chamber
      B)Constant bubbling in the suction-control chamber
      C)Occasional bubbling in the water-seal chamber
      D)Fluctuations in the fluid level in the water-seal chamber
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    Exam Review

    1. A nurse is caring for a client who has a chest tube connected to a closed drainage system and needs to be transported to the x-ray department. Which of the following actions should the nurse take?
      A)Disconnect the chest tube from the drainage system during transport.
      B)Clamp the chest tube prior to transferring the client to a wheelchair.
      C)Empty the collection chamber prior to transport.
      D)Keep the drainage system below the level of the client's chest at all times.
    2. A nurse is reviewing a client's laboratory report of arterial blood gas (ABG) findings: pH 7.28, HCO3 18 mEq/L, and PaCO2 36 mm Hg. Which of the following conditions should the nurse anticipate when interpreting these findings?
      A)Metabolic alkalosis
      B)Metabolic acidosis
      C)Respiratory alkalosis
      D)Respiratory acidosis
    3. A nurse in the PACU is assessing a client who has an endotracheal tube (ET) tube in place and observes the absence of left-sided chest wall expansion upon respiration. Which of the following complications should the nurse suspect?
      A)Blockage of the ET tube by the client's tongue
      B)Movement of the ET tube into the right main bronchus
      C)Passage of the ET tube into the esophagus
      D)Infection of the vocal cords
    4. The nurse would explain that emergency treatment of a tension pneumothorax requires
      A)a small stab wound with a skin blade made into the pleural space.
      B)covering the chest wall wound with gauze.
      C)immediate tracheostomy.
      D)insertion of an 14-gauge needle into the pleural space.
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    Exam Review

    1. Which set of arterial blood gases will the nurse expect to find in a client who developed a pulmonary embolism 15 minutes ago?
      A)pH, 7.30; HCO3, 22 mEq/L; PCO2, 60 mm Hg; PO2, 66 mm Hg
      B)pH, 7.38; HCO3, 22 mEq/L; PCO2, 45 mm Hg; PO2, 96 mm Hg
      C)pH, 7.47; HCO3, 23 mEq/L; PCO2, 25 mm Hg; PO2, 82 mm Hg
      D)pH, 7.30; HCO3, 28 mEq/L; PCO2, 65 mm Hg; PO2, 75 mm Hg
    2. The nurse assesses a client during suctioning. Which finding indicates that the procedure should be stopped?
      A)Heart rate increases 10 beats/min
      B)Respiratory rate increases from 16 to 20 breaths/min
      C)Blood pressure increases from 110/70 to 120/80 mm Hg
      D)Heart rate decreases from 78 to 40 beats/min
    3. Mrs. D is a 50 year old female admitted with a history of diabetes. Her vital signs are: T-101.9, HR= 110, RR= 30, BP=90/70. Labs reveal a glucose of 780. Her ABG reveals: pH 7.25 PaCO2 30 HCO3 22 What interventions should be included in her plan of care for this disorder?
      A)K+ replacement, Diamox
      B)sedatives or analgesics, breathe into a paper bag, mechanical ventilation to decrease rate
      C)vigorous pulmonary toilet, antibiotics, diuretics, mechanical ventilation
      D)IVF's, insulin, oxygen therapy
    4. A patient is on mechanical ventilation with + 20 of PEEP. Which finding below indicates the patient is developing a complication related to their therapy and requires immediate treatment?
      A)HCO3 28 mmHg
      B)PaO2 79 mmHg
      C)Blood pressure 70/45
      D)PaCO2 32 mmHg
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    Exam Review

    1. Which of the following assessments indicates an early sign of hypoxemia?
      A)Clubbing of nail beds
      B)Cyanosis
      C)Hypotension
      D)Restlessness
    2. Following lung resection surgery, the patient loses 350 ml of blood in the chest drainage system during the first hour post-op. The priority action for the nurse is to:
      A)clamp the chest tube to avoid further blood loss.
      B)monitor the chest tube drainage every 15 minutes for 1 hour.
      C)contact the physician to report possible hemorrhage.
      D)administer protamine to reverse the bleeding.
    3. A short-acting agent that can be administered for sedation and anesthesia is:
      A)midazolam (Versed).
      B)morphine sulfate.
      C)propofol (Diprivan).
      D)vecuronium (Norcuron).
    4. A client will need serial blood pressure monitoring and frequent blood sampling for ABG's and diagnostic studies. Which of the following vascular devices should the nurse recommend?
      A)PICC line
      B)Arterial line
      C)Central line
      D)Swanz-Ganz catheter
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    Exam Review

    1. A 65-year-old male is admitted to the progressive care unit with a diagnosis of pneumonia. He has a past history of pulmonary disease and diabetes. A set of arterial blood gases is obtained on admission: room air includes the following: pH 7.35; PaCO2 55 mm Hg; bicarbonate 30 mEq/L; PaO2 65 mm Hg. These levels reflect:
      A)hypoxemia and compensated metabolic acidosis.
      B)hypoxemia and compensated respiratory acidosis.
      C)normal oxygenation and partly compensated metabolic alkalosis.
      D)normal oxygenation and uncompensated respiratory acidosis
    2. A patient is having difficulty weaning from mechanical ventilation. Which of the following might be a cause of inability to wean?
      A)Cardiac output of 6 L/min
      B)Hemoglobin of 8 g/dL
      C)Sputum culture and sensitivity are negative
      D)White blood cell count of 8000
    3. An RN is observing a nursing student who is open suctioning a hospitalized patient with a tracheostomy in place. Which action by the student requires the RN to intervene?
      A)The student preoxygenates the patient for 1 minute before suctioning.
      B)The student puts on clean gloves and uses a sterile catheter to open suction.
      C)The student inserts the catheter about 5 inches into the tracheostomy tube.
      D)The student applies suction for 10 seconds while withdrawing the catheter.
    4. A client's arterial blood gas (ABG) results are as follows: pH 7.54 PaCO2 29 PaO2 103 HCO3 24 SaO2 94% Based on his ABG results, what would be some appropriate interventions?
      A)No action required at this time
      B)Increase the rate and decrease tidal volume
      C)Decrease the rate and tidal volume
      D)Increase the FIO2
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