A nurse plans care for a client with chronic obstructive pulmonary disease (COPD) understanding that the client is most likely to experience what type of acid-base imbalance?

Correct Answer: A

Rationale: The correct answer is A: Respiratory acidosis. In COPD, the client has impaired gas exchange leading to retention of carbon dioxide, causing respiratory acidosis. This imbalance occurs due to decreased ability to exhale carbon dioxide effectively. Respiratory alkalosis (B) is unlikely as COPD results in CO2 retention. Metabolic acidosis (C) would involve non-respiratory causes. Metabolic alkalosis (D) is not typically associated with COPD. Thus, A is the most likely acid-base imbalance in COPD.

Correct Answer: B

Rationale: The correct answer is B because in a right pneumothorax, there is a loss of breath sounds on auscultation due to air in the pleural space preventing lung expansion and sound transmission. This absence of breath sounds is a classic finding in pneumothorax. A: Bilateral inspiratory and expiratory crackles are indicative of conditions like pneumonia or pulmonary fibrosis, not pneumothorax. C: Inspiratory wheezes suggest conditions like asthma or bronchitis, not pneumothorax. D: Bilateral pleural friction rub is typically heard in conditions like pleurisy or pleural effusion, not pneumothorax.

Correct Answer: C

Rationale: The correct answer is C: Bronchospasm. Bronchospasm is a serious complication after a bronchoscopy that can lead to respiratory distress. It requires immediate medical attention to prevent further complications. A dry cough (A) may be expected post-procedure. Hematuria (B) is unrelated to a bronchoscopy. Blood-streaked sputum (D) is common after a biopsy and may not require immediate attention unless it becomes excessive. Reporting bronchospasm promptly is crucial in preventing respiratory compromise.

Correct Answer: B

Rationale: The correct answer is B: 3 L/min. Emphysema patients have compromised lung function, so high oxygen flow rates can lead to oxygen toxicity. 3 L/min is the recommended maximum flow rate to prevent oxygen toxicity while still providing adequate oxygenation. Choices A, C, and D exceed the safe limit and can lead to hyperoxia, absorption atelectasis, and other complications in emphysema patients. Therefore, B is the correct choice to ensure optimal oxygen therapy without causing harm.

Correct Answer: A

Rationale: The correct answer is A because the theophylline blood level of 13 mcg/mL is within the therapeutic range (10-20 mcg/mL). Therefore, the next dose should be administered as ordered to maintain therapeutic levels. Choice B is incorrect as skipping doses can lead to subtherapeutic levels. Choice C is unnecessary as the level is within range. Choice D is irrelevant to the theophylline level.