Question 1

A postoperative patient's nasogastric drainage has been 500 mL in the last 8 hours.The nurse would assess this patient for findings associated with which acid-base imbalance?

Accepted Answer

Loss of gastric fluids through nasogastric drainage can lead to metabolic alkalosis due to the loss of hydrochloric acid, which is a component of gastric secretions. This loss can result in an increase in blood pH.

Question 2

The nurse is assessing an 80-year-old patient who has no underlying respiratory pathology but whose carbon dioxide level is slightly elevated.The nurse would contribute this increase to which changes associated with normal aging? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

With aging, there is an increase in the size of the airways and an increase in air trapping, both of which can contribute to elevated carbon dioxide levels in the absence of respiratory pathology.

Question 3

A patient with pulmonary edema has a respiratory rate of 28 per minute.The nurse plans care for this patient based on which change in the lungs?

Accepted Answer

Pulmonary edema is the accumulation of fluid in the lungs, which results in decreased compliance of the lungs. This decreased compliance makes it harder for the patient to breathe, and as a result, they may have an increased respiratory rate. Therefore, the nurse will plan care based on the decreased compliance of the lungs. Options A and B are incorrect because increased work of breathing and muscle activity are associated with pulmonary edema. Option C is also incorrect because dehydration of the lung tissues is not a change seen in pulmonary edema.

Question 4

A patient's PaO₂ is 88 mm Hg while on FiO₂ of 0.50.What can the nurse conclude about this patient's intrapulmonary shunt? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

The answer of A patient's PaO₂ is 88 mm Hg...

Question 5

A 40-year-old postoperative patient has a hemoglobin level of 8 g/dL and an SaO₂ of 95%.Considering all aspects,what conclusion would the nurse make about this patient's condition?

Accepted Answer

A hemoglobin level of 8 g/dL is low and indicates that the patient has anemia. This, combined with a relatively normal SaO2 level of 95%, suggests that the patient may have a potential risk of hypoxia. An SaO2 level of 95% is within the normal range for most adults but may not be sufficient for this patient, who is postoperative and likely has increased oxygen demands. Therefore, the nurse should closely monitor this patient for signs of hypoxia and consider oxygen therapy if necessary. Choices A, B, and D are incorrect because they do not take into account the patient's hemoglobin level and oxygen demands.

Question 6

The patient has been diagnosed with early stage pneumonia.The nurse would anticipate which laboratory results?

Accepted Answer

In early stage pneumonia, the patient often experiences a decrease in PaO2 due to impaired gas exchange in the lungs, while PaCO2 may remain normal as the body compensates by increasing respiration to blow off CO2.

Question 7

A patient's PaO₂ level is 76 mm Hg.The nurse would be least concerned regarding this finding in which patient?

Accepted Answer

In an 83-year-old patient, a PaO2 level of 76 mm Hg might be considered within acceptable limits due to the natural decrease in lung function and oxygenation with age. In contrast, for patients recovering from anesthesia, smokers, or those who are intubated, such a level might indicate potential concerns that need to be addressed.

Question 8

A patient with severe chronic respiratory illness suddenly develops a high fever.The nurse would plan care for this patient based on which understanding of the fever's impact on the oxyhemoglobin dissociation curve? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

A fever can cause the oxyhemoglobin dissociation curve to shift to the right, which means that oxygen is more readily released to the tissues. However, this can also lead to potential tissue hypoxia if the body's demand for oxygen exceeds the supply, especially in patients with severe chronic respiratory illnesses. This shift is opposite to what occurs in alkalosis, where the curve shifts to the left, and hemoglobin binds oxygen more tightly.

Question 9

The nurse is assessing a patient with an endotracheal tube and notes decreased breath sounds on the left with normal sounds on the right.Which condition may cause this? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

Decreased breath sounds on one side can be due to misplacement of the endotracheal tube or a large infiltrate in the lung on that side. A right pneumothorax could cause decreased breath sounds on the right, not the left, and high pulmonary pressures or partial obstruction of the endotracheal tube would not cause unilateral decreased breath sounds.

Question 10

The patient complains that he awakens "two or three" times every night because he is so short of breath.The nurse would ask additional assessment questions about which condition?

Accepted Answer

Paroxysmal nocturnal dyspnea is a condition that causes a person to awaken from sleep gasping for breath. Patients with this condition may experience shortness of breath, wheezing, coughing, and difficulty breathing at night. It is important for the nurse to ask additional questions to determine the cause and severity of the patient's symptoms.

Question 11

The nurse is auscultating a patient's lung fields and hears a coarse sound like bubbling water.The sounds are heard best on expiration and in the center of the patient's chest.How should the nurse document these sounds?

Accepted Answer

The coarse sound like bubbling water heard best on expiration and in the center of the patient's chest is consistent with rhonchi. Crackles usually sound like fine, high-pitched crackling or popping sounds heard on inspiration, wheezes sound like a high-pitched whistling sound, and stridor is a harsh, high-pitched sound usually heard on inspiration that suggests upper airway obstruction.

Question 12

A patient is undergoing testing to differentiate her airway disorder as being restrictive or obstructive.The nurse would evaluate a normal result on which test to indicate a restrictive disorder is present?

Accepted Answer

The answer of A patient is undergoing testing to differentiate...

Question 13

A nurse is participating on a committee charged with the task of choosing capnography equipment for a new emergency department (ED).The nurse should present which information regarding these choices? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

Accepted Answer

B) Mainstream analyzers are typically used with intubated patients, providing real-time CO2 measurements directly in the patient's airway. C) Colorimetric capnography uses a color change to confirm the presence of CO2, which is helpful in verifying the correct placement of endotracheal tubes. D) Mainstream analyzers indeed provide continuous end-tidal CO2 (ETCO2) measurements, offering immediate feedback on the patient's respiratory status.

Question 14

A patient's arterial blood gases (ABGs)are as follows: pH 7.30,PaCO₂ 30 mm Hg,HCO₃ 14 mEq/L,and PaO₂ 50.The nurse evaluates these ABGs as representing which acid-base imbalance?

Accepted Answer

The low pH and low HCO3- indicate acidosis, and the high PaCO2 indicates respiratory compensation. However, the pH is still below normal range, indicating partial compensation. The oxygen level is also below normal, but not severe enough to be considered severe hypoxemia. Therefore, this represents a partially compensated metabolic acidosis with moderate hypoxemia.

Question 15

The nurse is assessing the nutritional intake of a patient diagnosed with chronic carbon dioxide retention.Which patient report indicates the patient requires additional information about dietary choices?

Accepted Answer

Choice C indicates the patient may be consuming too much carbohydrate, which can increase carbon dioxide production during metabolism, potentially exacerbating chronic carbon dioxide retention. Patients with this condition should be advised to balance their intake to avoid foods that could lead to increased CO2 production.

Question 16

The arterial blood gases of a patient with a large mass in the right lung show increasing hypoxemia and the patient will be intubated for placement on a mechanical ventilator.In which position should the nurse place this patient until intubation is begun?

Accepted Answer

Placing the patient on the left side with the head of the bed elevated to 30 degrees can improve oxygenation by optimizing ventilation-perfusion matching as the right lung mass compresses the right lung and decreases oxygenation. This position can also improve lung compliance and reduce the risk of aspiration. Lying flat on either side can further compromise oxygenation and increase the risk of aspiration.

Question 17

The nurse is planning to use a respiratory spirometer to measure the amount of air that moves in and out of a patient's lungs with each normal breath.How will the nurse document the results of this test?

Accepted Answer

Tidal volume is the amount of air that moves in and out of the lungs during a normal breath. This is exactly what the nurse is measuring with the respiratory spirometer. Vital capacity is the total amount of air that can be exhaled after taking a deep breath, forced expiratory volume is the amount of air exhaled forcefully during the first second of exhalation, and minute ventilation is the total amount of air moved into and out of the lungs in one minute. These measurements are not specifically related to a single normal breath, so they are not the best choice for documenting the results of this test.

Question 18

A patient,diagnosed with diabetic ketoacidosis,presents with Kussmaul respirations at a rate of 28.A newly licensed nurse asks the patient to try to slow his breathing.What instruction should the preceptor provide?

Accepted Answer

Kussmaul respirations are a compensatory mechanism in which the body tries to eliminate excess acids by increasing the ventilation rate. Therefore, instructing the patient to slow down their breathing would be counterproductive as it could lead to further acid accumulation. It is important to let the patient set their own respiratory rate to effectively compensate for the acidosis.

Question 19

A nurse who is evaluating a patient's arterial blood gases (ABGs)has determined that the patient's pH is acidic.What is the next question the nurse would ask in this interpretation?

Accepted Answer

The answer of A nurse who is evaluating a patient's...

Question 20

A patient was extubated in the postanesthesia recovery room prior to transfer to the intensive care unit (ICU).Upon admission to the ICU the patient is sedated,but will arouse when stimulated.Blood pressure is 106/68 mm/Hg,heart rate is 68 and regular,temperature is 97.8°F,and respirations are 12 bpm.The nurse would monitor this patient for which changes in arterial blood gases?

Accepted Answer

The patient is sedated and has a decreased respiratory rate, so it is likely that the patient is experiencing respiratory acidosis. This is confirmed by the decreased pH and increased PaCO2 levels. There is no indication that the patient is experiencing metabolic changes, so options A and B can be ruled out. Option D suggests a decrease in pH and decrease in HCO3-, which would indicate metabolic acidosis, but again there is no indication that the patient is experiencing metabolic changes.

Quiz 11: Determinants and Assessment of Pulmonary Function

A postoperative patient's nasogastric drainage has been 500 mL in the last 8 hours.The nurse would assess this patient for findings associated with which acid-base imbalance?

A patient with pulmonary edema has a respiratory rate of 28 per minute.The nurse plans care for this patient based on which change in the lungs?

A patient's PaO₂ is 88 mm Hg while on FiO₂ of 0.50.What can the nurse conclude about this patient's intrapulmonary shunt? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A 40-year-old postoperative patient has a hemoglobin level of 8 g/dL and an SaO₂ of 95%.Considering all aspects,what conclusion would the nurse make about this patient's condition?

The patient has been diagnosed with early stage pneumonia.The nurse would anticipate which laboratory results?

A patient's PaO₂ level is 76 mm Hg.The nurse would be least concerned regarding this finding in which patient?

The nurse is assessing a patient with an endotracheal tube and notes decreased breath sounds on the left with normal sounds on the right.Which condition may cause this? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

The patient complains that he awakens "two or three" times every night because he is so short of breath.The nurse would ask additional assessment questions about which condition?

The nurse is auscultating a patient's lung fields and hears a coarse sound like bubbling water.The sounds are heard best on expiration and in the center of the patient's chest.How should the nurse document these sounds?

A patient is undergoing testing to differentiate her airway disorder as being restrictive or obstructive.The nurse would evaluate a normal result on which test to indicate a restrictive disorder is present?

A patient's arterial blood gases (ABGs) are as follows: pH 7.30,PaCO₂ 30 mm Hg,HCO₃ 14 mEq/L,and PaO₂ 50.The nurse evaluates these ABGs as representing which acid-base imbalance?

The nurse is assessing the nutritional intake of a patient diagnosed with chronic carbon dioxide retention.Which patient report indicates the patient requires additional information about dietary choices?

The arterial blood gases of a patient with a large mass in the right lung show increasing hypoxemia and the patient will be intubated for placement on a mechanical ventilator.In which position should the nurse place this patient until intubation is begun?

The nurse is planning to use a respiratory spirometer to measure the amount of air that moves in and out of a patient's lungs with each normal breath.How will the nurse document the results of this test?

A patient,diagnosed with diabetic ketoacidosis,presents with Kussmaul respirations at a rate of 28.A newly licensed nurse asks the patient to try to slow his breathing.What instruction should the preceptor provide?

A nurse who is evaluating a patient's arterial blood gases (ABGs) has determined that the patient's pH is acidic.What is the next question the nurse would ask in this interpretation?

Quiz 11: Determinants and Assessment of Pulmonary Function

A postoperative patient's nasogastric drainage has been 500 mL in the last 8 hours.The nurse would assess this patient for findings associated with which acid-base imbalance?

A patient with pulmonary edema has a respiratory rate of 28 per minute.The nurse plans care for this patient based on which change in the lungs?

A patient's PaO2 is 88 mm Hg while on FiO2 of 0.50.What can the nurse conclude about this patient's intrapulmonary shunt? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A 40-year-old postoperative patient has a hemoglobin level of 8 g/dL and an SaO2 of 95%.Considering all aspects,what conclusion would the nurse make about this patient's condition?

The patient has been diagnosed with early stage pneumonia.The nurse would anticipate which laboratory results?

A patient's PaO2 level is 76 mm Hg.The nurse would be least concerned regarding this finding in which patient?

The nurse is assessing a patient with an endotracheal tube and notes decreased breath sounds on the left with normal sounds on the right.Which condition may cause this? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

The patient complains that he awakens "two or three" times every night because he is so short of breath.The nurse would ask additional assessment questions about which condition?

The nurse is auscultating a patient's lung fields and hears a coarse sound like bubbling water.The sounds are heard best on expiration and in the center of the patient's chest.How should the nurse document these sounds?

A patient is undergoing testing to differentiate her airway disorder as being restrictive or obstructive.The nurse would evaluate a normal result on which test to indicate a restrictive disorder is present?

A patient's arterial blood gases (ABGs) are as follows: pH 7.30,PaCO2 30 mm Hg,HCO3 14 mEq/L,and PaO2 50.The nurse evaluates these ABGs as representing which acid-base imbalance?

The nurse is assessing the nutritional intake of a patient diagnosed with chronic carbon dioxide retention.Which patient report indicates the patient requires additional information about dietary choices?

The arterial blood gases of a patient with a large mass in the right lung show increasing hypoxemia and the patient will be intubated for placement on a mechanical ventilator.In which position should the nurse place this patient until intubation is begun?

The nurse is planning to use a respiratory spirometer to measure the amount of air that moves in and out of a patient's lungs with each normal breath.How will the nurse document the results of this test?

A patient,diagnosed with diabetic ketoacidosis,presents with Kussmaul respirations at a rate of 28.A newly licensed nurse asks the patient to try to slow his breathing.What instruction should the preceptor provide?

A nurse who is evaluating a patient's arterial blood gases (ABGs) has determined that the patient's pH is acidic.What is the next question the nurse would ask in this interpretation?

A patient's PaO₂ is 88 mm Hg while on FiO₂ of 0.50.What can the nurse conclude about this patient's intrapulmonary shunt? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A 40-year-old postoperative patient has a hemoglobin level of 8 g/dL and an SaO₂ of 95%.Considering all aspects,what conclusion would the nurse make about this patient's condition?

A patient's PaO₂ level is 76 mm Hg.The nurse would be least concerned regarding this finding in which patient?

A patient's arterial blood gases (ABGs) are as follows: pH 7.30,PaCO₂ 30 mm Hg,HCO₃ 14 mEq/L,and PaO₂ 50.The nurse evaluates these ABGs as representing which acid-base imbalance?