The nurse reviews arterial blood gas results for a patient with respiratory distress: pH 7.25, PaCO2 55 mm Hg, HCO3- 26 mEq/L. What is the interpretation?

Correct Answer: B

Rationale: The correct answer is B: Uncompensated respiratory acidosis. The low pH (acidosis) and high PaCO2 (respiratory component) indicate respiratory acidosis. The HCO3- level is within normal range, suggesting no metabolic compensation. Therefore, it is uncompensated respiratory acidosis. Option A is incorrect because the pH is not within the normal range, indicating partial compensation has not occurred. Option C is incorrect as the HCO3- level is normal, ruling out metabolic acidosis. Option D is incorrect because the patient's pH is acidic, not alkalotic.

Correct Answer: A

Rationale: Step 1: Monitoring vital signs for changes is crucial to assess the patient's overall condition and response to treatment. Step 2: Vital signs include temperature, pulse rate, respiratory rate, and blood pressure. Step 3: Improvement in vital signs such as decreased temperature, heart rate, and respiratory rate would indicate treatment effectiveness. Step 4: Respiratory status and oxygen saturation levels are important but may not provide a comprehensive assessment of treatment efficacy. Step 5: Administering antibiotics is part of the treatment plan but does not directly indicate treatment effectiveness. Summary: Monitoring vital signs for changes is the most direct and reliable way to assess the effectiveness of treatment for pneumonia, making it the correct choice. The other options may provide valuable information but are not as direct indicators of treatment efficacy.

Correct Answer: A

Rationale: The correct answer is A: Administer intravenous fluids. In acute pancreatitis, fluid resuscitation is crucial to maintain circulation and prevent hypovolemic shock. It helps support organ perfusion and prevent complications like acute kidney injury. Providing a high-protein diet (B) is contraindicated as the pancreas needs to rest. Administering insulin (C) may be needed for hyperglycemia but is not the priority. Monitoring respiratory status (D) is important, but fluid resuscitation takes precedence to stabilize the patient's condition.

Correct Answer: A

Rationale: The correct answer is A: Administer an inhaler. During an asthma attack, the priority is to open the airways to improve breathing. Administering an inhaler with a bronchodilator medication helps to relax the muscles around the airways, making it easier for the patient to breathe. This intervention addresses the immediate respiratory distress the patient is experiencing. Monitoring oxygen saturation (C) is important but not the priority as administering the inhaler takes precedence in managing the acute respiratory distress. Administering IV epinephrine (B) is not typically recommended as a first-line treatment for asthma attacks. Administering antiemetics (D) is not relevant to managing an asthma attack.

Correct Answer: B

Rationale: The correct answer is B: Administer aspirin. Aspirin helps to reduce clot formation and minimize damage during a myocardial infarction (MI). This intervention is a priority because it can potentially save the patient's life by preventing further complications. Administering oxygen therapy (choice A) is important, but aspirin takes precedence due to its immediate impact on the outcome. Administering analgesics (choice C) can be considered after aspirin administration to address pain. Monitoring vital signs (choice D) is essential, but providing aspirin should be the initial priority to address the underlying cause of the MI.