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A patient, age 22, is admitted with acute asthma. The patient shows a pulse oximetry level of SaO2 of 82%. How should the nurse interpret this?
- A. Only 82% of the red blood cells are able to use oxygen.
- B. There is only 82% of oxygen bound to the hemoglobin compared with the amount available.
- C. Eighteen percent of oxygen is not dissolved in the blood.
- D. The muscular respiratory effort is only 18% effective.
Correct Answer: B
Rationale: An SaO2 of 82% indicates that only 82% of the available oxygen is bound to the hemoglobin.
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An 83-year-old patient is admitted with a temperature of 102°F (38.8°C), chest pain, and fatigue. Which term describes the infected fluid that the health care provider removes from the pleural cavity?
- A. Emboli
- B. Emphysema
- C. Sputum
- D. Empyema
Correct Answer: D
Rationale: If the fluid between the lung and the membrane lining the pleural cavity becomes infected, it is called empyema.
When assessing the SaO2 with a pulse oximeter, the nurse will place the oximeter on a finger with which consideration?
- A. on the same side as the blood pressure cuff.
- B. while exercising the arm to stimulate circulation.
- C. that is a normal temperature.
- D. on the same side as an arterial catheter.
Correct Answer: C
Rationale: The pulse oximeter should be placed on a finger of the hand that is normal temperature because hypothermia will affect the reading. The device should not be put on a finger on the same side as a blood pressure cuff or arterial line.
How will the kidneys respond in respiratory acidosis?
- A. Retain bicarbonate to increase the pH.
- B. Excrete more urine to reduce potassium.
- C. Concentrate the urine to conserve circulating fluid in the bloodstream.
- D. Lower the pH by excretion of bicarbonate.
Correct Answer: A
Rationale: In respiratory acidosis, the pH is low. The kidneys will retain bicarbonate to increase the pH.
The older adult patient with long-term emphysema reports experiencing a sharp pleuritic pain after a severe period of coughing. The patient's heart rate and respiratory rate have increased. Auscultation reveals no breath sounds on the left side. These are signs and symptoms of which condition?
- A. Pulmonary embolus
- B. Spontaneous pneumothorax
- C. Early signs of unilateral pneumonia
- D. An attack of asthma
Correct Answer: B
Rationale: Spontaneous pneumothorax can be caused by a ruptured bleb in a patient with long-term emphysema. The disorder causes chest pain, dyspnea, and anxiety associated with air hunger.
A problem for the patient with a new laryngectomy would be feelings of isolation due to being unable to communicate verbally. Which nursing intervention is appropriate?
- A. Complete care quickly.
- B. Provide a pad and pencil or magic slate.
- C. Refrain from conversations with the patient to reduce stress level.
- D. Offer books or jigsaw puzzles for entertainment.
Correct Answer: B
Rationale: Provide patient with implements for communication. Rapidly completing care and provision of solitary activities does not reduce social isolation.