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Question 1 of 5

A 52-year-old female client is admitted to the hospital in acute renal failure. She has been on hemodialysis for the past 2 years. Stat arterial blood gases are drawn on the client yielding the following results: pH 7.30, PCO2 51 mm Hg, HCO3 18 mEq/L, PaO2 84 mm Hg. The nurse would interpret these results as:

Correct Answer: D

Rationale: Compensated metabolic alkalosis would be reflected by the following: pH within normal limit (7.35-7.45), PCO2 >45 mm Hg, HCO3 >26 mEq/L. Respiratory acidosis would be reflected by the following: pH <7.35, PCO2 >45 mm Hg, HCO3 within normal limits (22-26 mEq/L). Partially compensated metabolic alkalosis would be reflected by the following: pH >7.45, PCO2 >45 mm Hg, HCO3 >26 mEq/L. Combined respiratory and metabolic acidosis would be reflected by the following: pH <7.35, PCO2 >45 mm Hg, HCO3 <22 mEq/L.

Question 2 of 5

The client at 38 weeks gestation is admitted with a blood pressure of 150/100,proteinuria and edema. The nurse should prepare to administer which of the following medications?

Correct Answer: A

Rationale: The client’s symptoms (hypertension proteinuria edema) indicate preeclampsia. Magnesium sulfate is administered to prevent seizures (eclampsia). Terbutaline is a tocolytic hydralazine treats hypertension and betamethasone is for fetal lung maturity in preterm labor.

Question 3 of 5

Which of the following signs and symptoms indicates a tension pneumothorax as compared to an open pneumothorax?

Correct Answer: C

Rationale: The tension pneumothorax acts like a one-way valve so that the pneumothorax increases with each breath. Eventually, it occupies enough space to shift mediastinal tissue toward the unaffected side away from the midline. Tracheal deviation, movement of point of maximum impulse, and decreased cardiac output will occur. The other three options will occur in both types of pneumothorax.

Question 4 of 5

A 40-year-old client has been admitted to the hospital with severe substernal chest pain radiating down his left arm. The nurse caring for the client establishes the following priority nursing diagnosis--Alteration in comfort, pain related to:

Correct Answer: A

Rationale: Anaerobic metabolism results because the decreased blood supply to the myocardium causes a release of lactic acid. Lactic acid is an irritant to the myocardial neural receptors, producing chest pain. Chest pain is caused by a decrease in the O2 supply to the myocardial cells. Treatment modalities for chest pain are aimed toward increasing the blood flow through coronary arteries. Chest pain causes an increase in the stimulation of the sympathetic nervous system. This stimulation increases the heart rate and blood pressure, causing an increase in myocardial workload aggravating the chest pain. Chest pain and anxiety cause increased secretion of catecholamines by stimulating the sympathetic nervous system. This stimulation increases chest pain by increasing the workload of the heart.

Question 5 of 5

The nurse is teaching a client with a history of hypertension about lifestyle modifications. The nurse should tell the client to:

Correct Answer: A

Rationale: Reducing stress lowers blood pressure in hypertension, improving cardiovascular health.

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