Nokea
Which phrase describes the function of a buffer?
- A. To excrete weak acids.
- B. To secrete hydrogen ions.
- C. To convert strong acids to weak acids.
- D. To convert ammonia to ammonium ions.
Correct Answer: C
Rationale: Buffers convert strong acids to weak acids by neutralizing them, helping maintain stable pH in bodily fluids.
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A patient reports episodic chest pain lasting a few minutes that is provoked by exertion and relieved within 10 minutes upon resting. Which cause of the patient's symptoms would the nurse suspect?
- A. Spasm of a major coronary artery.
- B. Exposure of the thrombogenic surface to plaque.
- C. Myocardial ischemia due to coronary artery disease.
- D. Myocardial ischemia secondary to microvascular disease.
Correct Answer: C
Rationale: Myocardial ischemia due to coronary artery disease causes chest pain provoked by exertion and relieved by rest, characteristic of stable angina.
Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?
- A. pH = 7.46, PaCO2 = 44 mm Hg, PaO2 = 95 mm Hg, and HCO3 = 36 mEq/L.
- B. pH = 7.27, PaCO2 = 70 mm Hg, PaO2 = 80 mm Hg, and HCO3 = 26 mEq/L.
- C. pH = 7.30, PaCO2 = 35 mm Hg, PaO2 = 70 mm Hg, and HCO3 = 20 mEq/L.
- D. pH = 7.52, PaCO2 = 24 mm Hg, PaO2 = 85 mm Hg, and HCO3 = 24 mEq/L.
Correct Answer: D
Rationale: Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg). The data in option D (pH = 7.52, PaCO2 = 24 mm Hg) indicates respiratory alkalosis.
The nurse receives information about the assigned patients during shift report. Which patient would the nurse assess first?
- A. A patient who reports dizziness with a blood pressure (BP) of 150/92 mm Hg.
- B. A patient who reports a severe headache and has begun vomiting.
- C. A patient with a hip fracture who reports a pain level of 2 on a 1-to-10 scale.
- D. A patient who received an angiotensin-converting enzyme (ACE) inhibitor 30 minutes previously and reports fatigue.
Correct Answer: B
Rationale: A severe headache and vomiting could be indicative of a serious neurological condition such as a stroke, intracranial bleeding, or increased intracranial pressure. This patient needs urgent assessment and intervention to prevent potential complications.
After noting that a patient with leukemia has thrombocytopenia, which action will the nurse plan to take?
- A. Palpate lymph nodes for swelling.
- B. Check temperature for elevation.
- C. Inspect skin for bruising or petechiae.
- D. Examine oral mucosa for ulceration.
Correct Answer: C
Rationale: Inspecting the skin for bruising or petechiae is specific to thrombocytopenia, as petechiae are small, red or purple dots that appear on the skin when platelet count is low, indicating a bleeding tendency.
In which type of water would a submersion injury cause the patient's fluid to be drawn from the vascular space into the alveoli, impairing alveolar ventilation and resulting in hypoxia?
- A. Hypotonic saltwater.
- B. Hypertonic saltwater.
- C. Hypotonic freshwater.
- D. Hypertonic freshwater.
Correct Answer: B
Rationale: Hypertonic saltwater draws fluid into the alveoli due to its higher solute concentration, impairing ventilation and causing hypoxia.