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Which acid-base disturbances commonly occurs with the hyperventilation and impaired gas exchange seen in severe exacerbation of asthma?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: D
Rationale: The correct answer is D: Respiratory alkalosis. Hyperventilation in severe asthma exacerbation leads to excessive removal of CO2, causing a decrease in carbonic acid levels, resulting in respiratory alkalosis. Metabolic acidosis (A) is not typically associated with hyperventilation. Metabolic alkalosis (B) is caused by excessive loss of acid or gain of bicarbonate, not by hyperventilation. Respiratory acidosis (C) is characterized by an increase in CO2 levels due to inadequate ventilation, which is the opposite of what occurs in severe asthma exacerbation.
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represent?
- A. Alveolar oxygen tension.
- B. Oxygen that is chemically combined with hemoglobin .
- C. Oxygen that is physically dissolved in plasma.
- D. Total oxygen consumption.
Correct Answer: B
Rationale: The correct answer is B: Oxygen that is chemically combined with hemoglobin. This is because oxygen primarily travels in the blood by binding to hemoglobin in red blood cells, forming oxyhemoglobin. This process allows for efficient transport of oxygen to tissues throughout the body. Choices A, C, and D are incorrect because:
A: Alveolar oxygen tension refers to the partial pressure of oxygen in the alveoli of the lungs, not the specific form of oxygen in the blood.
C: Oxygen physically dissolved in plasma refers to the small amount of oxygen that is not bound to hemoglobin and is less significant in oxygen transport compared to oxygen bound to hemoglobin.
D: Total oxygen consumption is the overall amount of oxygen utilized by the body, not specifically the form of oxygen bound to hemoglobin for transport.
The nurse is caring for a patient receiving continuous norepinephrine (Levophed) IV infusion. Which patient assessment finding indicates that the infusion rate may need to be adjusted?
- A. Heart rate is 58 beats/minute.
- B. Mean arterial pressure (MAP) is 56 mm Hg.
- C. Systemic vascular resistance (SVR) is elevated.
- D. Pulmonary artery wedge pressure (PAWP) is low.
Correct Answer: B
Rationale: The correct answer is B because a low Mean Arterial Pressure (MAP) indicates inadequate perfusion, which may require adjusting the norepinephrine infusion rate to increase blood pressure. A: A heart rate of 58 beats/minute is within a normal range and may not necessarily indicate a need for adjustment. C: Elevated Systemic Vascular Resistance (SVR) may be an expected response to norepinephrine and does not necessarily indicate a need for adjustment. D: A low Pulmonary Artery Wedge Pressure (PAWP) may indicate fluid volume deficit but does not directly relate to the need for adjusting norepinephrine infusion rate.
The nurse is caring for an older adult patient who is in card iogenic shock and has failed to respond to medical treatment. The primary care provider conducts a conference to explain that they have exhausted treatment options and suggest that the patient be made a “do not resuscitate” status. This scenario illustrates what medical concept?
- A. Brain death
- B. Futility
- C. Incompetence
- D. Life-prolonging procedures
Correct Answer: B
Rationale: The correct answer is B: Futility. In this scenario, the primary care provider suggests making the patient a "do not resuscitate" status because further medical treatment is deemed futile. Futility refers to situations where medical interventions are unlikely to achieve the desired outcome. This decision is made when the benefits of continuing treatment do not outweigh the burdens on the patient.
Summary:
A: Brain death does not apply here as the patient is not brain dead.
C: Incompetence refers to the patient's ability to make decisions, not the medical concept being illustrated.
D: Life-prolonging procedures are not being discussed; the focus is on the futility of further treatment.
The transplant clinic coordinator is evaluating relatives of a patient with end-stage renal disease, whose blood type is A positive, for suitability as aa bliirvb.icnogm /dteostn or for kidney transplantation. Which family member best qualifies for evaluation?
- A. A 65-year-old brother with a history of hypertension; b lood type A positive
- B. A 35-year-old female with a history of food allergies; blood type O negative
- C. A 14-year-old son, otherwise healthy with no history; blood type B negative
- D. A 70-year-old mother, with a history of sinus infection s; blood type A positive
Correct Answer: D
Rationale: The correct answer is D, the 70-year-old mother with blood type A positive. This choice is the best candidate for evaluation due to her blood type matching the patient's (A positive) for kidney transplantation. Age and medical history are also crucial factors in determining suitability. The 65-year-old brother (choice A) has hypertension, a significant risk factor. The 35-year-old female (choice B) with food allergies may have potential complications. The 14-year-old son (choice C) is underage and might not be a suitable donor due to age and the potential impact on his growth and development. In summary, choice D aligns with the matching blood type and age, making the mother the most suitable candidate for evaluation.
The nurse notes premature ventricular contractions (PVCs) while suctioning a patient’s endotracheal tube. Which action by the nurse is a priority?
- A. Decrease the suction pressure to 80 mm Hg.
- B. Document the dysrhythmia in the patient’s chart.
- C. Stop and ventilate the patient with 100% oxygen.
- D. Give antidysrhythmic medications per protocol.
Correct Answer: C
Rationale: The correct answer is C: Stop and ventilate the patient with 100% oxygen. This is the priority action because PVCs can lead to life-threatening arrhythmias and inadequate oxygenation. By stopping suctioning and providing 100% oxygen, the nurse ensures proper oxygenation and ventilation, which takes precedence over addressing the dysrhythmia itself. Decreasing suction pressure (choice A) may not address the underlying issue and could potentially harm the patient. Documenting the dysrhythmia (choice B) is important but not as urgent as ensuring adequate oxygenation. Giving antidysrhythmic medications (choice D) should be done under the direction of a healthcare provider and is not the first-line intervention in this situation.