EAQ ABG Questions to study

A client with esophageal varices has severe hematemesis, and a Sengstaken-Blakemore tube is inserted. What design and purpose does the tube have?

A. Triple-lumen; for esophageal compression B. Single-lumen to gastric compression C. Double-lumen for esophageal and gastric compression D. Single-lumen for esophageal compression

A nurse is caring for a client after abdominal surgery and encourages the client to turn from side to side and to engage in deep-breathing exercises. What complication is the nurse trying to prevent? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

C. Respiratory acidosis

Which long-term effect is associated with untreated congenital hypothyroidism? A. Myxedema B. Thyrotoxicosis C. Spastic paralysis D. Cognitive impairment

D. Cognitive impairment Congenital hypothyroidism is the result of insufficient secretion by the thyroid gland because of an embryonic defect. A decreased level of thyroid hormone affects the fetus before birth during cerebral development, so it is likely that there will be some cognitive impairments at birth. Treatment before 3 months of age will prevent further damage.

What does the nurse consider to be the priority nursing intervention for a client on diuretic therapy who has developed metabolic alkalosis? a) Preventing falls b) Monitoring electrolytes c) Administering antiemetics d) Adjusting the diuretic therapy

a) Preventing falls-A client with alkalosis has hypotension and muscle weakness, which increases the risk for injury due to falls; therefore, to prevent injury, the priority nursing care is to prevent falls.

which arterial blood gas (ABG) Value would indicate diabetic ketoacidosis?

decreased HCO3

On admission to an intensive care unit, a client is diagnosed with compensated metabolic acidosis. The nurse expects which assessment finding?

deep and rapid respirations

A client appears anxious, with respirations that are shallow and 40 per minute. The client reports feeling dizzy and light-headed and having tingling sensations of the fingertips and around the lips. What does the nurse determine is the probable cause of these clinical manifestations? a. Eupnea b. Hyperventilation c. Kussmaul respirations d. Carbon dioxide intoxication

hyperventilation

Which insulin should the nurse prepare for the emergency treatment of ketoacidosis? 1. Glargine (Lantus) 2. NPH insulin (Novolin N) 3. Insulin aspart (NovoLog) 4. Insulin detemir (Levemir)

Insulin aspart (NovoLog)

which assessment would the nurse perform while caring for an infant with a tentative diagnosis of hypertrophic pyloric stenosis? 1. quality of the cry 2. signs of dehydration 3. coughing up of feedings 4. characteristics of stool

2. signs of dehydration

Which diagnosis is a client most likely to have who has an arterial blood gas report indicating that pH is 7.25, PCO2 is 35 mm Hg, and HCO3 is 20 mEq/L (20 mmol/L)? a.) Panic attack b.) Persistent vomiting c.) Diabetic ketoacidosis d.) Advanced emphysema

Diabetic ketoacidosis-The low pH and bicarbonate levels are consistent with metabolic acidosis, which can be caused by excess ketones, a result of diabetic ketoacidosis. Persistent vomiting will cause metabolic alkalosis and high HCO3 from loss of gastric hydrochloric acid. Panic attacks lead to hyperventilation and respiratory alkalosis with low PCO2. Advanced emphysema causes elevated PCO2 and respiratory acidosis.

When the chest x-ray for a client who has arrived at the emergency department with chest trauma shows multiple fractured ribs, which action will the nurse take next? a. administer prescribed Morphine sulfate b. Assist the client to take deep breaths and cough c. Check for paradoxical movement of the chest wall d. teach the client about ways to manage rib pain

Check for paradoxical movement of the chest wall. Flail chest can occur when multiple ribs are fractured and can comprise breathing efforts because of paradoxical movement during inspiration and expiration. It may require intubation nd mechanical ventilation.

A client diagnosed with gastroesophageal reflux disease (GERD) is being treated with antacid therapy. When teaching the client about the therapy, what does the nurse reinforce? A. Antacids should be taken 1 hour before meals. B. These should be scheduled at 4-hour intervals. C. Antacid tablets are just as fast and effective as the liquid form. D. Antacids commonly interfere with the absorption of other drugs.

D. Antacids commonly interfere with the absorption of other drugs.

A nurse is reviewing the diagnostic blood tests of a client with a diagnosis of type 1 diabetes. Which laboratory results support the nurse's suspicion that the client is experiencing ketoacidosis? A.) Blood glucose of 40 mg/100 mL, blood pH of 7.37 B.) Blood glucose of 130 mg/100 mL, blood pH of 7.35 C.) Blood glucose of 650 mg/100 mL, blood pH of 7.42 D.) Blood glucose of 300 mg/100 mL, blood pH of 7.20

Blood glucose of 300 mg/100 mL, blood pH of 7.20 The blood glucose level of 300 mg/100 mL is above the expected range of individuals with type 1 diabetes, indicating hyperglycemia . The normal serum pH is 7.35 to 7.45; therefore, 7.20 indicates acidosis. The blood glucose level of 40 mg/100 mL is below the expected range for all individuals, indicating hypoglycemia; the serum pH of 7.37 is within the expected range for pH. The blood glucose level of 130 mg/100 mL is within the expected range for individuals with type 1 diabetes and the pH of 7.35 is within the expected range for pH. The blood glucose level of 650 mg/100 mL indicates hyperglycemia but the serum pH is within the expected range for pH

which descriptors for maturity-onset diabetes of the young (MODY) would the nurse identify as accurate? a. Autosomal dominant b. Characterized by young age of onset c. Associated with obesity and hypertension d. Polygenic (>25 genes affect susceptibility) e. Combination of inadequate insulin secretion and resistance.

-Autosomal dominant -Characterized by young age of onset.

which conditions are cardiovascular manifestations of alkalosis? -increased heart rate -decreased heart rate -increased digitalis toxicity -widened QRS complex -Short PR interval

-increased heart rate -increased digitalis toxicity

When a client returns from the postanesthetic care unit after a kidney transplant, the nurse should plan to measure the client's urinary output every: 1. 15 minutes 2. One hour 3. Two hours 4. Three hours

2. One hour

A client is admitted to the hospital with a diagnosis of diabetic ketoacidosis. What is the initial intervention that the nurse should expect the health care provider to prescribe for this client? A.) Intravenous (IV) fluids B.) Potassium C.) NPH insulin (Novolin N) D.) Sodium polystyrene sulfonate (Kayexalate)

Intravenous (IV) fluids IV Fluids are given to combat dehydration in ketoacidosis and to keep an IV line open for administration of medications.

The serum potassium level of a client who has diabetic ketoacidosis is 5.4 mEq/L (5.4 mmol/L). What would the nurse expect to see on the ECG tracing monitor? 1. Abnormal P waves and depressed T waves 2. Peaked T waves and widened QRS complexes 3. Abnormal Q waves and prolonged ST segments 4. Peaked P waves and an increased number of T waves

2. Peaked T waves and widened QRS complexes Potassium is the principal intracellular cation, and during ketoacidosis it moves out of cells into the extracellular compartment to replace potassium lost as a result of glucose-induced osmotic diuresis; overstimulation of the cardiac muscle results. The T wave is depressed in hypokalemia. Initially, the QT segment is short, and as the potassium level rises, the QRS complex widens. P waves are abnormal because the PR interval may be prolonged and the P wave may be lost; however, the T wave is peaked, not depressed. The ST segment becomes depressed. The PR interval is prolonged, and the P wave may be lost. QRS complexes and thus T waves become irregular, and the rate does not necessarily change.

A nitrazine test strip that turns deep blue indicates that the fluid being tested has a pH of: 1.) 4.5 2.) 5.5 3.) 6.5 4.) 7.5

7.5

The nurse is caring for a client who is vomiting. When caring for this client, the nurse recalls that the vomiting reflex follows a set pattern. List the steps in the order that they occur .1) Closure of the trachea to prevent aspiration 2) Initiation of reverse peristalsis in the stomach 3) Contraction of abdominal muscles 4) Relaxation of the upper esophageal sphincter

A. 2, 3, 4, 1 B. 3,4,1,2 C. 4' 3,2,1 D. 3,2,4,1

An arterial blood gas report indicates the client's pH is 7.25, PCO2 is 35 mm Hg, and HCO3 is 20 mEq/L. Which disturbance should the nurse identify based on these results? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

Metabolic acidosis A low pH and low bicarbonate level are consistent with metabolic acidosis. The pH indicates acidosis. The CO2 concentration is within normal limits, which is inconsistent with respiratory acidosis; it is elevated with respiratory acidosis.

A client is admitted to the hospital after taking an overdose of aspirin. A nasogastric tube is inserted for lavage. Which solution should the nurse obtain for the gastric lavage? a. NS b. LR c. Citrate Mag d. Sodium bicarb

NS this considered a physiological or isotonic solution appropriate for gastric lavage b/c it will not detrimentally influence the client's acid-base balance.

Which type of acid-base imbalance would the nurse expect in a child admitted with a severe asthma exacerbation? -Metabolic acidosis caused by the kidneys' inability to compensate for increased carbonic acid formation. -Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid -Respiratory alkalosis caused by accelerated respirations and loss of carbon dioxide -Metabolic alkalosis caused by excessive production of acid metabolites

Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid

An increase in which blood component is responsible for the acidosis related to untreated diabetes mellitus? a. Ketones b. Glucose c. Lactic Acid d. Glutamic acid

a. Ketones Ketones produced excessively in diabetes are a byproduct of the breakdown of body fats and proteins for energy; this occurs when insulin is not secreted or is unable to be used to transport glucose across the cell membrane into the cells.

When the nurse is reviewing a client's arterial blood gas results, which finding would the nurse identify as being consistent with respiratory alkalosis? a. A decreased pH, elevated PCO2 b. An elevated pH, decreased PCO2 c. A decreased pH, decreased PCO2 d. An elevated pH, elevated partial pressure of carbon dioxide (PCO2)

b. An elevated pH, decreased PCO2

When a client who has had a thoracotomy develops respiratory acidosis, which action would the nurse take? a. Administer oral fluids. b. Encourage deep breathing. c. Increase the oxygen flow rate. d. Perform naso-tracheal suctioning

b. Encourage deep breathing.

Which arterial blood gas report is indicative of diabetic ketoacidosis? a. Pco2: 49, HCO3: 32, pH: 7.50 b. Pco2: 26, HCO3: 20, pH: 7.52 c. Pco2: 54, HCO3: 28, pH: 7.30 d. Pco2: 28, HCO3: 18, pH: 7.28

d. Pco2: 28, HCO3: 18, pH: 7.28 Decreased pH and bicarb values reflect metabolic acidosis; a decreased Pco2 value indicates compensatory hyperventilation.

The arterial blood gases for a client with acute respiratory distress are pH 7.30, PaO2 80 mm Hg, PaCO2 55, and HCO3 23. How would the RN interpret these findings? a. Hypoxemia b. Hypocapnia c. Compensated metabolic acidosis d. Uncompensated respiratory acidosis

d. Uncompensated respiratory acidosis