Nokea
A healthcare professional is reviewing a patient's arterial blood gas values. Which of the following conditions apply under the following values?
pH- 7.49
Bicarbonate ion 24 mEq/dl
PaCO2 - 31 mmHg
PaO2 - 52 mmHg
FiO2 - 0.22
- A. respiratory acidosis
- B. respiratory alkalosis
- C. metabolic acidosis
- D. metabolic alkalosis
Correct Answer: B
Rationale: The given blood gas values indicate respiratory alkalosis. A high pH and low PaCO2 level are consistent with respiratory alkalosis. In this scenario, no compensation for the alkalosis is noted, ruling out metabolic acidosis or alkalosis. Metabolic conditions would usually involve changes in bicarbonate levels, which remain within the normal range in this case.
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The manic client has just interrupted the group session with the counselor for the 4th time, explaining that she already knows this information on 'dealing with others when you are down' and constantly gets up and goes to the front. What should the nurse do at this time?
- A. Engage the client to walk with you to make another pot of coffee
- B. Ask the client to reflect on their behavior to determine if it is appropriate
- C. Ask the group to tell the client how they feel when she interrupts
- D. Instruct the client to perform jumping jacks and count aloud to get rid of some energy
Correct Answer: A
Rationale: In this situation, it is important to redirect the client's energy and focus. Engaging the client in a purposeful activity like making another pot of coffee can help distract them from disruptive behavior and provide an outlet for their excess energy. This choice also helps in maintaining a therapeutic environment by involving the client in a constructive task. Asking the client to reflect on their behavior (Choice B) might not be effective during a manic episode as the client may not be in a state to critically analyze their actions. Asking the group to tell the client how they feel (Choice C) can escalate the situation and may not be appropriate in this context. Instructing the client to perform jumping jacks and count aloud (Choice D) may not address the underlying issue of disruptive behavior and may not be suitable for the current situation.
The nurse observes a nursing assistant performing AM care for a client with a new leg cast. Which action by the assistant will the nurse intervene?
- A. Lifting the affected leg with the palms of the hands
- B. Covering the affected leg with a blanket to avoid chills
- C. Placing plastic over the groin prior to bathing
- D. Elevating the casted leg on two pillows
Correct Answer: B
Rationale: The correct answer is to intervene when the assistant covers the affected leg with a blanket to avoid chills. A new cast should not be covered to allow the heat from the cast to evaporate, preventing complications. Lifting the affected leg with the palms of the hands is appropriate for proper handling. Placing plastic over the groin prior to bathing is a standard practice to protect the client's privacy and maintain hygiene. Elevating the casted leg on two pillows helps reduce swelling and promote circulation, making it a suitable action.
Which client should the nurse see first?
- A. Recurring crushing chest pain
- B. Needing an IV for surgery in 5 minutes
- C. Needing PCA morphine for pain control post-hysterectomy
- D. Waiting to get back to bed after sitting in a chair for 30 minutes
Correct Answer: A
Rationale: The client presenting with recurring crushing chest pain should be seen first as this symptom could indicate a myocardial infarction (MI), which is a life-threatening condition requiring immediate attention. Assessing and managing potential cardiac issues take priority over other concerns like needing an IV for surgery, pain control post-hysterectomy, or assistance with mobility. While all clients require care, addressing the chest pain promptly is crucial to ensure the client's safety and well-being.
What is the number one reason a person with alcohol addiction does not seek treatment?
- A. Co-dependency
- B. Denial
- C. Depression
- D. Stigma
Correct Answer: B
Rationale: The correct answer is B: Denial. Individuals with alcohol addiction often deny that they have a drinking problem and may become defensive when confronted about it. This sense of denial can be a significant barrier to seeking treatment. Co-dependency, referred to in choice A, is a relationship dynamic and is not the primary reason for avoiding treatment. Depression, as mentioned in choice C, is a common co-occurring condition with alcohol addiction but is not typically the main factor preventing treatment-seeking. Stigma, as in choice D, can act as a deterrent, but denial of the problem itself is usually the primary obstacle to seeking help.
The nurse is preparing for a dressing change on a full thickness burn to the flank area. The orders include irrigating the wound with each dressing change. To irrigate the wound, what will the nurse use?
- A. Sterile saline
- B. Distilled water
- C. Betadine scrub
- D. Tap water
Correct Answer: A
Rationale: When irrigating a wound, especially in the case of a full-thickness burn, it is crucial to use a solution that is gentle and non-irritating to the tissues. Sterile saline is the preferred choice for wound irrigation as it is isotonic and does not cause additional damage to the already compromised tissue. Distilled water lacks the electrolytes present in saline, Betadine scrub is not used for irrigation due to its potential to be cytotoxic, and tap water may introduce contaminants and microorganisms to the wound.