Nokea
A patient's arterial blood gas (ABG) values include a pH of 7.48, a PaCO2 of 38, and an HCO3- of 30. Around which acid-base imbalance would the nurse plan the patient's care?
- A. Metabolic acidosis.
- B. Metabolic alkalosis.
- C. Respiratory acidosis.
- D. Respiratory alkalosis.
Correct Answer: B
Rationale: Metabolic alkalosis is indicated by a high pH (7.48) and elevated HCO3- (30 mEq/L), with normal PaCO2, suggesting no respiratory involvement.
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Which information would the nurse include when discussing pain due to chronic stable angina with the patient?
- A. Occurs with both activity and rest.
- B. Generally lasts 10-15 minutes or more.
- C. Does not subside when the precipitating factor is resolved.
- D. Occurs intermittently over a period of time in a similar pattern.
Correct Answer: D
Rationale: Chronic stable angina occurs intermittently in a predictable pattern, triggered by exertion and relieved by rest or nitroglycerin.
Which treatment is likely to be planned for a patient who develops pernicious anemia after a gastrectomy?
- A. Triple-drug therapy.
- B. IV therapy.
- C. Quadruple-drug therapy.
- D. Cobalamin replacement therapy.
Correct Answer: D
Rationale: Cobalamin replacement therapy is the standard treatment for pernicious anemia caused by vitamin B12 deficiency due to lack of intrinsic factor post-gastrectomy.
Which laboratory report finding would support the nurse's conclusion that a patient has thalassemia major? Select all that apply.
- A. Increased bilirubin levels.
- B. Increased reticulocyte level.
- C. Increased mean corpuscular volume.
- D. Increased total iron-binding capacity.
Correct Answer: A,B,D
Rationale: Increased bilirubin, reticulocyte levels, and total iron-binding capacity are seen in thalassemia major due to hemolysis, bone marrow response, and increased iron absorption.
Which explanation will the nurse give a patient with non-Hodgkin lymphoma about the purpose of a planned lumbar puncture?
- A. To rule out any bone marrow involvement.
- B. To determine the level of cell differentiation.
- C. To establish which lymph cell type is involved.
- D. To find any central nervous system involvement.
Correct Answer: D
Rationale: A lumbar puncture in non-Hodgkin lymphoma is used to detect central nervous system involvement by examining cerebrospinal fluid for lymphoma cells.
Which change occurs first, making patients susceptible to coronary artery disease?
- A. Formation of thrombus in the coronary artery.
- B. Formation of fibrous plaque in the endothelium.
- C. Reduction of blood flow through the coronary arteries.
- D. Development of fatty streaks in the smooth muscles of the endothelium.
Correct Answer: D
Rationale: Development of fatty streaks in the endothelium is the initial change in atherosclerosis, predisposing patients to coronary artery disease.