Nokea
The nurse suspects that which condition associated with chronic heart failure is the cause of a patient's inability to sleep well due to frequent urination?
- A. Fullness from ascites.
- B. Hypoproteinemia.
- C. Hypoperfusion to the brain.
- D. Increased renal perfusion in the supine position.
Correct Answer: D
Rationale: Increased renal perfusion in the supine position causes nocturia in heart failure due to fluid redistribution from the lower extremities to the kidneys when lying down.
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A patient with chronic obstructive pulmonary disease (COPD) has the following arterial blood gas (ABG) results: a blood pH of 7.29, a partial pressure of carbon dioxide (PaCO2) level of 49 mm Hg, and a bicarbonate ion (HCO3) level of 25 mEq/L. Which condition would the nurse have in mind when developing the patient's plan of care?
- A. Metabolic acidosis.
- B. Metabolic alkalosis.
- C. Respiratory acidosis.
- D. Respiratory alkalosis.
Correct Answer: C
Rationale: Respiratory acidosis is indicated by low pH (7.29) and high PaCO2 (49 mm Hg), common in COPD due to impaired CO2 elimination.
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.
Which acid-base mechanism would the kidney use to buffer a patient's acidosis (serum pH <7.35)? Select all that apply.
- A. Eliminating excess H+.
- B. Excreting excess water.
- C. Eliminating excess CO2.
- D. Reabsorbing additional HCO3-.
- E. Reabsorbing additional sodium ions.
Correct Answer: A,D
Rationale: The kidneys buffer acidosis by eliminating excess hydrogen ions (H+) and reabsorbing additional bicarbonate ions (HCO3-) to neutralize acid and raise pH.
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.
Which component forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process?
- A. Serotonin.
- B. Platelet factor III.
- C. Von Willebrand factor.
- D. Adenosine diphosphate.
Correct Answer: C
Rationale: Von Willebrand factor forms an adhesive bridge between platelets and vascular subendothelial structures, crucial for hemostasis at sites of vascular injury.