Nokea
A client complains of a dull headache and dizziness and has an increased pulse rate. The results of arterial blood gas analysis are as follows: pH 7.26; partial pressure of carbon dioxide,50 mm Hg; and bicarbonate, 24 mEq/L. These findings indicate which of the following acid-base imbalances?
- A. Respiratory alkalosis
- B. Respiratory acidosis
- C. Metabolic acidosis
- D. Metabolic alkalosis
Correct Answer: B
Rationale: A pH of 7.26 (acidic) with elevated CO2 (50 mm Hg) and normal bicarbonate (24 mEq/L) indicates respiratory acidosis, likely due to hypoventilation. Other imbalances do not match these values.
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The nurse is caring for a neonate with jaundice receiving phototherapy. Which action is most important?
- A. Cover the neonate's eyes.
- B. Apply lotion to the skin.
- C. Keep the neonate swaddled.
- D. Monitor urine output daily.
Correct Answer: A
Rationale: Covering the neonate's eyes protects them from retinal damage due to phototherapy light exposure.
A client is prescribed buspirone (BuSpar) 5mg two times a day. Which of the following statements indicates that the client has understood the nurse's teaching about this drug? Select all that apply.
- A. This medicine will make me sleepy
- B. BuSpar will relax my muscles
- C. My anxiety will be completely gone by tomorrow
- D. BuSpar will help me not to worry so much
- E. I'll be able to focus better
Correct Answer: D,E
Rationale: Buspirone reduces anxiety and improves focus without causing sedation or muscle relaxation. Expecting complete anxiety relief by tomorrow is unrealistic, as it takes weeks to be effective.
The nurse establishes the goal of preventing the development of a stress ulcer in a burn client. Which of the following interventions would most likely contribute to the achievement of this goal?
- A. Implementing relaxation exercises.
- B. Administering a sedative as needed.
- C. Administering prophylactic antacids or histamine-2 receptor antagonists.
- D. Monitoring the client's nutritional status closely.
Correct Answer: C
Rationale: Prophylactic antacids or H2 receptor antagonists reduce gastric acid, preventing stress ulcers in burn patients, who are at high risk due to stress response.
An adult client has been admitted to the hospital with a 3-day history of uncontrolled vomiting and diarrhea. Which should the nurse assess for in this client? Select all that apply.
- A. Excitability
- B. Bradycardia
- C. Hypertension
- D. Poor skin turgor
- E. Flat peripheral veins
Correct Answer: D,E
Rationale: The client described in the question will most likely be dehydrated because of uncontrolled vomiting and diarrhea. The nurse assesses this client for weight loss, lethargy, or headache; sunken eyes; poor skin turgor (such as tenting); flat neck and peripheral veins; tachycardia; and low blood pressure.
Which type of anemia is diagnosed with a Schilling test?
- A. Aplastic
- B. Pernicious
- C. Megaloblastic
- D. Iron deficiency
Correct Answer: B
Rationale: The Schilling test is used to determine the cause of vitamin B12 deficiency, a potential precursor to pernicious anemia. This test involves the use of a small oral dose of radioactive B12 and a large nonradioactive intramuscular dose. A 24-hour urine specimen is then collected to measure the amount of radioactivity in the urine, and thus radioactive B12. This test is not helpful in diagnosing aplastic, megaloblastic, or iron-deficiency anemia.