Question 1

The nurse is preparing to admit a client with acute pneumonia who is experiencing severe respiratory acidosis.Which treatments does the nurse anticipate as appropriate for this client? Select all that apply.

Accepted Answer

A) The client with acute pneumonia and respiratory acidosis may require oxygen administration to improve gas exchange, increased fluid intake to thin secretions, and frequent repositioning to preventing the pooling of respiratory sections. There is not enough evidence to know whether the client is experiencing heart failure as a result of the acute pneumonia.
B) The client with acute pneumonia and respiratory acidosis may require oxygen administration to improve gas exchange, increased fluid intake to thin secretions, and frequent repositioning to preventing the pooling of respiratory sections. There is not enough evidence to know whether the client is experiencing heart failure as a result of the acute pneumonia.
C) The client with acute pneumonia and respiratory acidosis may require oxygen administration to improve gas exchange, increased fluid intake to thin secretions, and frequent repositioning to preventing the pooling of respiratory sections. There is not enough evidence to know whether the client is experiencing heart failure as a result of the acute pneumonia.
D) The client with acute pneumonia and respiratory acidosis may require oxygen administration to improve gas exchange, increased fluid intake to thin secretions, and frequent repositioning to preventing the pooling of respiratory sections. There is not enough evidence to know whether the client is experiencing heart failure as a result of the acute pneumonia.
E) The client with acute pneumonia and respiratory acidosis may require oxygen administration to improve gas exchange, increased fluid intake to thin secretions, and frequent repositioning to preventing the pooling of respiratory sections. There is not enough evidence to know whether the client is experiencing heart failure as a result of the acute pneumonia.

Question 2

The nurse is reviewing new orders written for a client experiencing respiratory alkalosis.Which orders would be appropriate for this client's care needs? Select all that apply.

Accepted Answer

A) The client has respiratory alkalosis, which is caused by hyperventilation. Additional oxygen is not required. A fluid restriction is not required in the treatment of respiratory alkalosis. Management of respiratory alkalosis focuses on correcting the imbalance and treating the underlying cause. It is important to create a calm, quiet, low-stimulation environment to reduce the client's anxiety or panic. Sodium bicarbonate is used in the treatment of respiratory and metabolic acidosis. Arterial blood gases must be ordered prior to beginning medication or oxygen therapy.
B) The client has respiratory alkalosis, which is caused by hyperventilation. Additional oxygen is not required. A fluid restriction is not required in the treatment of respiratory alkalosis. Management of respiratory alkalosis focuses on correcting the imbalance and treating the underlying cause. It is important to create a calm, quiet, low-stimulation environment to reduce the client's anxiety or panic. Sodium bicarbonate is used in the treatment of respiratory and metabolic acidosis. Arterial blood gases must be ordered prior to beginning medication or oxygen therapy.
C) The client has respiratory alkalosis, which is caused by hyperventilation. Additional oxygen is not required. A fluid restriction is not required in the treatment of respiratory alkalosis. Management of respiratory alkalosis focuses on correcting the imbalance and treating the underlying cause. It is important to create a calm, quiet, low-stimulation environment to reduce the client's anxiety or panic. Sodium bicarbonate is used in the treatment of respiratory and metabolic acidosis. Arterial blood gases must be ordered prior to beginning medication or oxygen therapy.
D) The client has respiratory alkalosis, which is caused by hyperventilation. Additional oxygen is not required. A fluid restriction is not required in the treatment of respiratory alkalosis. Management of respiratory alkalosis focuses on correcting the imbalance and treating the underlying cause. It is important to create a calm, quiet, low-stimulation environment to reduce the client's anxiety or panic. Sodium bicarbonate is used in the treatment of respiratory and metabolic acidosis. Arterial blood gases must be ordered prior to beginning medication or oxygen therapy.
E) The client has respiratory alkalosis, which is caused by hyperventilation. Additional oxygen is not required. A fluid restriction is not required in the treatment of respiratory alkalosis. Management of respiratory alkalosis focuses on correcting the imbalance and treating the underlying cause. It is important to create a calm, quiet, low-stimulation environment to reduce the client's anxiety or panic. Sodium bicarbonate is used in the treatment of respiratory and metabolic acidosis. Arterial blood gases must be ordered prior to beginning medication or oxygen therapy.

Question 3

A client with pneumonia develops respiratory acidosis.Which medications should the nurse prepare to administer to this client? Select all that apply.

Accepted Answer

A) Bronchodilator drugs such as albuterol inhaler may be administered to open the airways and antibiotics such as amoxicillin may be prescribed to treat respiratory infections. Benzodiazepines such as diazepam are central nervous system depressants and would adversely affect this client's respiratory rate, adversely affecting respiratory acidosis. Potassium chloride is indicated in the treatment of metabolic alkalosis.
B) Bronchodilator drugs such as albuterol inhaler may be administered to open the airways and antibiotics such as amoxicillin may be prescribed to treat respiratory infections. Benzodiazepines such as diazepam are central nervous system depressants and would adversely affect this client's respiratory rate, adversely affecting respiratory acidosis. Potassium chloride is indicated in the treatment of metabolic alkalosis.
C) Bronchodilator drugs such as albuterol inhaler may be administered to open the airways and antibiotics such as amoxicillin may be prescribed to treat respiratory infections. Benzodiazepines such as diazepam are central nervous system depressants and would adversely affect this client's respiratory rate, adversely affecting respiratory acidosis. Potassium chloride is indicated in the treatment of metabolic alkalosis.
D) Bronchodilator drugs such as albuterol inhaler may be administered to open the airways and antibiotics such as amoxicillin may be prescribed to treat respiratory infections. Benzodiazepines such as diazepam are central nervous system depressants and would adversely affect this client's respiratory rate, adversely affecting respiratory acidosis. Potassium chloride is indicated in the treatment of metabolic alkalosis.
E) Bronchodilator drugs such as albuterol inhaler may be administered to open the airways and antibiotics such as amoxicillin may be prescribed to treat respiratory infections. Benzodiazepines such as diazepam are central nervous system depressants and would adversely affect this client's respiratory rate, adversely affecting respiratory acidosis. Potassium chloride is indicated in the treatment of metabolic alkalosis.

Question 4

The client is admitted to the emergency department (ED)with symptoms of a panic attack,including hyperventilation.Based on this data,the nurse plans care for which health problem?

Accepted Answer

A) Anxiety disorders increase the risk for the acid-base imbalance respiratory alkalosis, due to hyperventilation that accompanies anxiety and panic attacks. The client with anxiety does not necessarily have vomiting or memory loss as risk factors. Anxiety and panic attacks will lead to hyperventilation, not hypoventilation.
B) Anxiety disorders increase the risk for the acid-base imbalance respiratory alkalosis, due to hyperventilation that accompanies anxiety and panic attacks. The client with anxiety does not necessarily have vomiting or memory loss as risk factors. Anxiety and panic attacks will lead to hyperventilation, not hypoventilation.
C) Anxiety disorders increase the risk for the acid-base imbalance respiratory alkalosis, due to hyperventilation that accompanies anxiety and panic attacks. The client with anxiety does not necessarily have vomiting or memory loss as risk factors. Anxiety and panic attacks will lead to hyperventilation, not hypoventilation.
D) Anxiety disorders increase the risk for the acid-base imbalance respiratory alkalosis, due to hyperventilation that accompanies anxiety and panic attacks. The client with anxiety does not necessarily have vomiting or memory loss as risk factors. Anxiety and panic attacks will lead to hyperventilation, not hypoventilation.

Question 5

A client is admitted to the unit with chronic obstructive pulmonary disease.Blood gas analysis indicates respiratory acidosis.Based on this data,the nurse plans care based on which priority diagnosis?

Accepted Answer

A) Impaired Gas Exchange is the priority nursing diagnosis for the client with respiratory acidosis. Interventions are aimed at restoring effective alveolar ventilation and gas exchange. Anxiety and Ineffective Airway Clearance are both appropriate nursing diagnoses but not priority for the client with respiratory acidosis. There is no evidence to support Impaired Mobility for this client.
B) Impaired Gas Exchange is the priority nursing diagnosis for the client with respiratory acidosis. Interventions are aimed at restoring effective alveolar ventilation and gas exchange. Anxiety and Ineffective Airway Clearance are both appropriate nursing diagnoses but not priority for the client with respiratory acidosis. There is no evidence to support Impaired Mobility for this client.
C) Impaired Gas Exchange is the priority nursing diagnosis for the client with respiratory acidosis. Interventions are aimed at restoring effective alveolar ventilation and gas exchange. Anxiety and Ineffective Airway Clearance are both appropriate nursing diagnoses but not priority for the client with respiratory acidosis. There is no evidence to support Impaired Mobility for this client.
D) Impaired Gas Exchange is the priority nursing diagnosis for the client with respiratory acidosis. Interventions are aimed at restoring effective alveolar ventilation and gas exchange. Anxiety and Ineffective Airway Clearance are both appropriate nursing diagnoses but not priority for the client with respiratory acidosis. There is no evidence to support Impaired Mobility for this client.

Question 6

The nurse is preparing discharge instructions for an older adult client recovering from respiratory acidosis caused by restrictive lung disease and pneumonia.Which topics should the nurse include in the discharge teaching for this client? Select all that apply.

Accepted Answer

A) For the client with a history of chronic lung disease and pneumonia, the nurse should instruct on the importance of receiving annual influenza immunizations, frequent hand washing, avoiding crowds, and covering the nose and mouth when coughing. Fluids should be encouraged to ensure that respiratory secretions are thin.
B) For the client with a history of chronic lung disease and pneumonia, the nurse should instruct on the importance of receiving annual influenza immunizations, frequent hand washing, avoiding crowds, and covering the nose and mouth when coughing. Fluids should be encouraged to ensure that respiratory secretions are thin.
C) For the client with a history of chronic lung disease and pneumonia, the nurse should instruct on the importance of receiving annual influenza immunizations, frequent hand washing, avoiding crowds, and covering the nose and mouth when coughing. Fluids should be encouraged to ensure that respiratory secretions are thin.
D) For the client with a history of chronic lung disease and pneumonia, the nurse should instruct on the importance of receiving annual influenza immunizations, frequent hand washing, avoiding crowds, and covering the nose and mouth when coughing. Fluids should be encouraged to ensure that respiratory secretions are thin.
E) For the client with a history of chronic lung disease and pneumonia, the nurse should instruct on the importance of receiving annual influenza immunizations, frequent hand washing, avoiding crowds, and covering the nose and mouth when coughing. Fluids should be encouraged to ensure that respiratory secretions are thin.

Question 7

The nurse is caring for a client who is being mechanically ventilated.Arterial blood gas analysis reveals a pH of 7.20 and a PaCO₂ of 49 mmHg.Which change in ventilator settings should the nurse anticipate?

Accepted Answer

A) This client is exhibiting respiratory acidosis. This client needs to "blow off" more CO₂; therefore, the respiratory rate would be increased. No other option given would serve to decrease CO₂ levels. B) This client is exhibiting respiratory acidosis. This client needs to "blow off" more CO₂; therefore, the respiratory rate would be increased. No other option given would serve to decrease CO₂ levels. C) This client is exhibiting respiratory acidosis. This client needs to "blow off" more CO₂; therefore, the respiratory rate would be increased. No other option given would serve to decrease CO₂ levels. D) This client is exhibiting respiratory acidosis. This client needs to "blow off" more CO₂; therefore, the respiratory rate would be increased. No other option given would serve to decrease CO₂ levels.

Question 8

A client with metabolic alkalosis is experiencing numbness around the mouth and tingling of the fingers.What should the nurse explain as the reason for these manifestations?

Accepted Answer

A) Alkalosis increases binding of extracellular calcium to albumin, reducing ionized calcium levels. As a result, neuromuscular excitability increases, and manifestations similar to hypocalcemia develop. These manifestations include circumoral and distal extremity paresthesias. Rapid breathing is not reducing the amount of oxygen reaching the nerve endings. Excessive carbon dioxide would lead to acidosis. Respiratory alkalosis is not caused by an imbalance of serum potassium.
B) Alkalosis increases binding of extracellular calcium to albumin, reducing ionized calcium levels. As a result, neuromuscular excitability increases, and manifestations similar to hypocalcemia develop. These manifestations include circumoral and distal extremity paresthesias. Rapid breathing is not reducing the amount of oxygen reaching the nerve endings. Excessive carbon dioxide would lead to acidosis. Respiratory alkalosis is not caused by an imbalance of serum potassium.
C) Alkalosis increases binding of extracellular calcium to albumin, reducing ionized calcium levels. As a result, neuromuscular excitability increases, and manifestations similar to hypocalcemia develop. These manifestations include circumoral and distal extremity paresthesias. Rapid breathing is not reducing the amount of oxygen reaching the nerve endings. Excessive carbon dioxide would lead to acidosis. Respiratory alkalosis is not caused by an imbalance of serum potassium.
D) Alkalosis increases binding of extracellular calcium to albumin, reducing ionized calcium levels. As a result, neuromuscular excitability increases, and manifestations similar to hypocalcemia develop. These manifestations include circumoral and distal extremity paresthesias. Rapid breathing is not reducing the amount of oxygen reaching the nerve endings. Excessive carbon dioxide would lead to acidosis. Respiratory alkalosis is not caused by an imbalance of serum potassium.

Question 9

The nurse is providing care to an older adult Asian-American client diagnosed with respiratory alkalosis.The nurse states to the client,"look into my eyes and breathe with me so that we can slow down your breathing rate." The client continues to look down and refuses to make eye contact with the nurse.The client's daughter later asks you to teach her how to help her mother to control her breathing.When documenting this client's care,which statement is appropriate for the nurse to include?

Accepted Answer

A) A method that is often used to control breathing for client's experiencing hyperventilation is eye contract with the nurse during breathing exercises. It is not uncommon in the Asian culture for eye contact to be deemed as a sign of disrespect. Documenting this finding in the medical record is appropriate. Saying the client is noncompliant is nontherapeutic and labels the client. There is no indication that the client does not speak English. The client's daughter wishes to help her mother control her breathing. This is not indicative of abuse.
B) A method that is often used to control breathing for client's experiencing hyperventilation is eye contract with the nurse during breathing exercises. It is not uncommon in the Asian culture for eye contact to be deemed as a sign of disrespect. Documenting this finding in the medical record is appropriate. Saying the client is noncompliant is nontherapeutic and labels the client. There is no indication that the client does not speak English. The client's daughter wishes to help her mother control her breathing. This is not indicative of abuse.
C) A method that is often used to control breathing for client's experiencing hyperventilation is eye contract with the nurse during breathing exercises. It is not uncommon in the Asian culture for eye contact to be deemed as a sign of disrespect. Documenting this finding in the medical record is appropriate. Saying the client is noncompliant is nontherapeutic and labels the client. There is no indication that the client does not speak English. The client's daughter wishes to help her mother control her breathing. This is not indicative of abuse.
D) A method that is often used to control breathing for client's experiencing hyperventilation is eye contract with the nurse during breathing exercises. It is not uncommon in the Asian culture for eye contact to be deemed as a sign of disrespect. Documenting this finding in the medical record is appropriate. Saying the client is noncompliant is nontherapeutic and labels the client. There is no indication that the client does not speak English. The client's daughter wishes to help her mother control her breathing. This is not indicative of abuse.

Question 10

The nurse is caring for the client with a history of anxiety who is experiencing chest pain,palpitations and dyspnea.Which intervention would be a priority for this client?

Accepted Answer

A) The client will require reassurance from the nurse that the symptoms being experienced are not those of a heart attack and that the symptoms will resolve when a normal breathing pattern returns to normal. Ordering the diet and instructing the respiratory therapist are done by the healthcare provider. Providing teaching for the client becomes a priority when the client is recovering from the illness.
B) The client will require reassurance from the nurse that the symptoms being experienced are not those of a heart attack and that the symptoms will resolve when a normal breathing pattern returns to normal. Ordering the diet and instructing the respiratory therapist are done by the healthcare provider. Providing teaching for the client becomes a priority when the client is recovering from the illness.
C) The client will require reassurance from the nurse that the symptoms being experienced are not those of a heart attack and that the symptoms will resolve when a normal breathing pattern returns to normal. Ordering the diet and instructing the respiratory therapist are done by the healthcare provider. Providing teaching for the client becomes a priority when the client is recovering from the illness.
D) The client will require reassurance from the nurse that the symptoms being experienced are not those of a heart attack and that the symptoms will resolve when a normal breathing pattern returns to normal. Ordering the diet and instructing the respiratory therapist are done by the healthcare provider. Providing teaching for the client becomes a priority when the client is recovering from the illness.

Question 11

A client is admitted to the emergency department for treatment of an overdose.The client's arterial blood gas results indicate acute respiratory acidosis.Which substance found on the nurse's review of the toxicology analysis is most likely the cause for the client's current condition?

Accepted Answer

A) Oxycodone is an opiate narcotic. Excessive use or overdose of narcotic substances can lead to respiratory depression and respiratory acidosis. Cocaine is a stimulant. Marijuana is not considered as a drug that depresses the central nervous system or respiratory center. PCP is a hallucinogenic agent.
B) Oxycodone is an opiate narcotic. Excessive use or overdose of narcotic substances can lead to respiratory depression and respiratory acidosis. Cocaine is a stimulant. Marijuana is not considered as a drug that depresses the central nervous system or respiratory center. PCP is a hallucinogenic agent.
C) Oxycodone is an opiate narcotic. Excessive use or overdose of narcotic substances can lead to respiratory depression and respiratory acidosis. Cocaine is a stimulant. Marijuana is not considered as a drug that depresses the central nervous system or respiratory center. PCP is a hallucinogenic agent.
D) Oxycodone is an opiate narcotic. Excessive use or overdose of narcotic substances can lead to respiratory depression and respiratory acidosis. Cocaine is a stimulant. Marijuana is not considered as a drug that depresses the central nervous system or respiratory center. PCP is a hallucinogenic agent.

Question 12

The nurse suspects a client with one functioning lung is developing chronic respiratory acidosis.Which manifestation did the nurse most likely assess in this client?

Accepted Answer

A) The manifestations of acute and chronic respiratory acidosis differ. The client with chronic respiratory acidosis will demonstrate daytime sleepiness. The client with acute respiratory acidosis may demonstrate warm, flushed skin, irritability, and blurred vision from the acute decline in oxygenation.
B) The manifestations of acute and chronic respiratory acidosis differ. The client with chronic respiratory acidosis will demonstrate daytime sleepiness. The client with acute respiratory acidosis may demonstrate warm, flushed skin, irritability, and blurred vision from the acute decline in oxygenation.
C) The manifestations of acute and chronic respiratory acidosis differ. The client with chronic respiratory acidosis will demonstrate daytime sleepiness. The client with acute respiratory acidosis may demonstrate warm, flushed skin, irritability, and blurred vision from the acute decline in oxygenation.
D) The manifestations of acute and chronic respiratory acidosis differ. The client with chronic respiratory acidosis will demonstrate daytime sleepiness. The client with acute respiratory acidosis may demonstrate warm, flushed skin, irritability, and blurred vision from the acute decline in oxygenation.

Question 13

The client with an anxiety disorder is ready to be discharged from the unit.What should the nurse plan to teach this client and family in preparation for discharge? Select all that apply.

Accepted Answer

A) Teaching the client to breathe slowly helps the client manage hyperventilation at home. The client with an anxiety disorder should be referred to counseling to assist with management of the disorder and should be taught signs of an impending panic attack. Eating foods high in acid will not counteract the results of hyperventilation. The use of paper bags has been a recommended treatment for hyperventilation; however, it can also cause hypoxia.
B) Teaching the client to breathe slowly helps the client manage hyperventilation at home. The client with an anxiety disorder should be referred to counseling to assist with management of the disorder and should be taught signs of an impending panic attack. Eating foods high in acid will not counteract the results of hyperventilation. The use of paper bags has been a recommended treatment for hyperventilation; however, it can also cause hypoxia.
C) Teaching the client to breathe slowly helps the client manage hyperventilation at home. The client with an anxiety disorder should be referred to counseling to assist with management of the disorder and should be taught signs of an impending panic attack. Eating foods high in acid will not counteract the results of hyperventilation. The use of paper bags has been a recommended treatment for hyperventilation; however, it can also cause hypoxia.
D) Teaching the client to breathe slowly helps the client manage hyperventilation at home. The client with an anxiety disorder should be referred to counseling to assist with management of the disorder and should be taught signs of an impending panic attack. Eating foods high in acid will not counteract the results of hyperventilation. The use of paper bags has been a recommended treatment for hyperventilation; however, it can also cause hypoxia.
E) Teaching the client to breathe slowly helps the client manage hyperventilation at home. The client with an anxiety disorder should be referred to counseling to assist with management of the disorder and should be taught signs of an impending panic attack. Eating foods high in acid will not counteract the results of hyperventilation. The use of paper bags has been a recommended treatment for hyperventilation; however, it can also cause hypoxia.

Question 14

The nurse instructs a client with a history of acute respiratory acidosis and lung infections on ways to prevent further episodes of the health problem.Which client statement indicates that teaching has been effective?

Accepted Answer

A) The nurse should discuss ways to avoid future episodes of acute respiratory infections by encouraging the client to receive immunization against pneumococcal pneumonia and influenza. Alcohol is a central nervous system depressant which can adversely affect respiratory status and lead to the development of respiratory acidosis. The ingestion of bananas and oranges will not promote the development of respiratory acidosis. The client should be instructed to complete a full course of antibiotics prescribed to treat infections.
B) The nurse should discuss ways to avoid future episodes of acute respiratory infections by encouraging the client to receive immunization against pneumococcal pneumonia and influenza. Alcohol is a central nervous system depressant which can adversely affect respiratory status and lead to the development of respiratory acidosis. The ingestion of bananas and oranges will not promote the development of respiratory acidosis. The client should be instructed to complete a full course of antibiotics prescribed to treat infections.
C) The nurse should discuss ways to avoid future episodes of acute respiratory infections by encouraging the client to receive immunization against pneumococcal pneumonia and influenza. Alcohol is a central nervous system depressant which can adversely affect respiratory status and lead to the development of respiratory acidosis. The ingestion of bananas and oranges will not promote the development of respiratory acidosis. The client should be instructed to complete a full course of antibiotics prescribed to treat infections.
D) The nurse should discuss ways to avoid future episodes of acute respiratory infections by encouraging the client to receive immunization against pneumococcal pneumonia and influenza. Alcohol is a central nervous system depressant which can adversely affect respiratory status and lead to the development of respiratory acidosis. The ingestion of bananas and oranges will not promote the development of respiratory acidosis. The client should be instructed to complete a full course of antibiotics prescribed to treat infections.

Question 15

The nurse has completed discharge teaching for a client with an anxiety disorder.Which client statement indicates that client teaching about respiratory alkalosis has been effective?

Accepted Answer

A) The client understands that reducing anxiety can reduce hyperventilation and respiratory alkalosis. Seeing a counselor can help the client develop alternative strategies for dealing with anxiety. Eating bananas is more appropriate for the client at risk for metabolic alkalosis who is on diuretics. Breathing faster will increase hyperventilation. Taking too many antacids is associated with metabolic alkalosis.
B) The client understands that reducing anxiety can reduce hyperventilation and respiratory alkalosis. Seeing a counselor can help the client develop alternative strategies for dealing with anxiety. Eating bananas is more appropriate for the client at risk for metabolic alkalosis who is on diuretics. Breathing faster will increase hyperventilation. Taking too many antacids is associated with metabolic alkalosis.
C) The client understands that reducing anxiety can reduce hyperventilation and respiratory alkalosis. Seeing a counselor can help the client develop alternative strategies for dealing with anxiety. Eating bananas is more appropriate for the client at risk for metabolic alkalosis who is on diuretics. Breathing faster will increase hyperventilation. Taking too many antacids is associated with metabolic alkalosis.
D) The client understands that reducing anxiety can reduce hyperventilation and respiratory alkalosis. Seeing a counselor can help the client develop alternative strategies for dealing with anxiety. Eating bananas is more appropriate for the client at risk for metabolic alkalosis who is on diuretics. Breathing faster will increase hyperventilation. Taking too many antacids is associated with metabolic alkalosis.

Question 16

The nurse is providing care to a client recently extubated for treatment of aspiration pneumonia and respiratory acidosis.Which action by the nurse provides an optimum environment for this client?

Accepted Answer

A) The client with respiratory acidosis often experiences anxiety. This client would benefit from having a family member in the room to provide reassurance. Restraining the client will increase levels of agitation. The client with respiratory failure would benefit most from the semi-Fowler's or Fowler's position to increase ventilation. Narcotics will depress the respirations and increase respiratory acidosis. A non-narcotic pain reliever would be considered if this client were experiencing pain.
B) The client with respiratory acidosis often experiences anxiety. This client would benefit from having a family member in the room to provide reassurance. Restraining the client will increase levels of agitation. The client with respiratory failure would benefit most from the semi-Fowler's or Fowler's position to increase ventilation. Narcotics will depress the respirations and increase respiratory acidosis. A non-narcotic pain reliever would be considered if this client were experiencing pain.
C) The client with respiratory acidosis often experiences anxiety. This client would benefit from having a family member in the room to provide reassurance. Restraining the client will increase levels of agitation. The client with respiratory failure would benefit most from the semi-Fowler's or Fowler's position to increase ventilation. Narcotics will depress the respirations and increase respiratory acidosis. A non-narcotic pain reliever would be considered if this client were experiencing pain.
D) The client with respiratory acidosis often experiences anxiety. This client would benefit from having a family member in the room to provide reassurance. Restraining the client will increase levels of agitation. The client with respiratory failure would benefit most from the semi-Fowler's or Fowler's position to increase ventilation. Narcotics will depress the respirations and increase respiratory acidosis. A non-narcotic pain reliever would be considered if this client were experiencing pain.

Question 17

A client is admitted to the hospital with sudden,severe abdominal pain.The client is diagnosed with respiratory alkalosis.Which arterial blood gas value does the nurse document to support this diagnosis?

Accepted Answer

A) Acute pain usually causes hyperventilation, which causes the CO₂ to drop and the client to experience respiratory alkalosis. The pH would denote alkalosis and would be higher than 7.45. HCO₃ would trend downwards as the kidneys begin to compensate for the alkalosis by excreting HCO₃. The PaO₂ is likely to be normal unless the client has been hyperventilating for a long time and is beginning to tire. B) Acute pain usually causes hyperventilation, which causes the CO₂ to drop and the client to experience respiratory alkalosis. The pH would denote alkalosis and would be higher than 7.45. HCO₃ would trend downwards as the kidneys begin to compensate for the alkalosis by excreting HCO₃. The PaO₂ is likely to be normal unless the client has been hyperventilating for a long time and is beginning to tire. C) Acute pain usually causes hyperventilation, which causes the CO₂to drop and the client to experience respiratory alkalosis. The pH would denote alkalosis and would be higher than 7.45. HCO₃ would trend downwards as the kidneys begin to compensate for the alkalosis by excreting HCO₃. The PaO₂ is likely to be normal unless the client has been hyperventilating for a long time and is beginning to tire. D) Acute pain usually causes hyperventilation, which causes the CO₂ to drop and the client to experience respiratory alkalosis. The pH would denote alkalosis and would be higher than 7.45. HCO₃ would trend downwards as the kidneys begin to compensate for the alkalosis by excreting HCO₃. The PaO₂ is likely to be normal unless the client has been hyperventilating for a long time and is beginning to tire.

Question 18

The nurse is caring for a client who has been admitted to the unit with respiratory failure and respiratory acidosis.Which data from the nursing history would the nurse suspect contributed to the client's current state of health?

Accepted Answer

A) Chronic lung disease such as asthma and cystic fibrosis put the child at risk for respiratory acidosis. Pneumonia and aspiration are both acute lung conditions. Hyperthyroidism is a disorder that results in metabolic acidosis.
B) Chronic lung disease such as asthma and cystic fibrosis put the child at risk for respiratory acidosis. Pneumonia and aspiration are both acute lung conditions. Hyperthyroidism is a disorder that results in metabolic acidosis.
C) Chronic lung disease such as asthma and cystic fibrosis put the child at risk for respiratory acidosis. Pneumonia and aspiration are both acute lung conditions. Hyperthyroidism is a disorder that results in metabolic acidosis.
D) Chronic lung disease such as asthma and cystic fibrosis put the child at risk for respiratory acidosis. Pneumonia and aspiration are both acute lung conditions. Hyperthyroidism is a disorder that results in metabolic acidosis.

Question 19

The nurse is reviewing prescriptions written for a client with chronic respiratory acidosis.Which prescription should the nurse question prior to implementation?

Accepted Answer

A) In clients with chronic respiratory acidosis, oxygen is administered cautiously to prevent carbon dioxide narcosis. Adequate hydration such as intravenous fluids is important to promote removal of respiratory secretions. Pulmonary hygiene measures such as breathing treatments may be instituted.
B) In clients with chronic respiratory acidosis, oxygen is administered cautiously to prevent carbon dioxide narcosis. Adequate hydration such as intravenous fluids is important to promote removal of respiratory secretions. Pulmonary hygiene measures such as breathing treatments may be instituted.
C) In clients with chronic respiratory acidosis, oxygen is administered cautiously to prevent carbon dioxide narcosis. Adequate hydration such as intravenous fluids is important to promote removal of respiratory secretions. Pulmonary hygiene measures such as breathing treatments may be instituted.
D) In clients with chronic respiratory acidosis, oxygen is administered cautiously to prevent carbon dioxide narcosis. Adequate hydration such as intravenous fluids is important to promote removal of respiratory secretions. Pulmonary hygiene measures such as breathing treatments may be instituted.

Question 20

The nurse is planning care for a client who has been admitted to the unit with a salicylate overdose.When preparing the plan of care,the nurse considers which to be a priority nursing diagnosis?

Accepted Answer

A) The client with a salicylate overdose is at risk for hyperventilation, which can lead to respiratory alkalosis. There is not enough information to know whether the client's mobility is impaired. Risk for Injury and Powerlessness are diagnoses to be considered for this client, but the highest priority is respiratory function.
B) The client with a salicylate overdose is at risk for hyperventilation, which can lead to respiratory alkalosis. There is not enough information to know whether the client's mobility is impaired. Risk for Injury and Powerlessness are diagnoses to be considered for this client, but the highest priority is respiratory function.
C) The client with a salicylate overdose is at risk for hyperventilation, which can lead to respiratory alkalosis. There is not enough information to know whether the client's mobility is impaired. Risk for Injury and Powerlessness are diagnoses to be considered for this client, but the highest priority is respiratory function.
D) The client with a salicylate overdose is at risk for hyperventilation, which can lead to respiratory alkalosis. There is not enough information to know whether the client's mobility is impaired. Risk for Injury and Powerlessness are diagnoses to be considered for this client, but the highest priority is respiratory function.

Quiz 1: Acidbase Balance

The nurse is preparing to admit a client with acute pneumonia who is experiencing severe respiratory acidosis.Which treatments does the nurse anticipate as appropriate for this client? Select all that apply.

The nurse is reviewing new orders written for a client experiencing respiratory alkalosis.Which orders would be appropriate for this client's care needs? Select all that apply.

A client with pneumonia develops respiratory acidosis.Which medications should the nurse prepare to administer to this client? Select all that apply.

The client is admitted to the emergency department (ED) with symptoms of a panic attack,including hyperventilation.Based on this data,the nurse plans care for which health problem?

A client is admitted to the unit with chronic obstructive pulmonary disease.Blood gas analysis indicates respiratory acidosis.Based on this data,the nurse plans care based on which priority diagnosis?

The nurse is preparing discharge instructions for an older adult client recovering from respiratory acidosis caused by restrictive lung disease and pneumonia.Which topics should the nurse include in the discharge teaching for this client? Select all that apply.

The nurse is caring for a client who is being mechanically ventilated.Arterial blood gas analysis reveals a pH of 7.20 and a PaCO₂ of 49 mmHg.Which change in ventilator settings should the nurse anticipate?

A client with metabolic alkalosis is experiencing numbness around the mouth and tingling of the fingers.What should the nurse explain as the reason for these manifestations?

The nurse is caring for the client with a history of anxiety who is experiencing chest pain,palpitations and dyspnea.Which intervention would be a priority for this client?

A client is admitted to the emergency department for treatment of an overdose.The client's arterial blood gas results indicate acute respiratory acidosis.Which substance found on the nurse's review of the toxicology analysis is most likely the cause for the client's current condition?

The nurse suspects a client with one functioning lung is developing chronic respiratory acidosis.Which manifestation did the nurse most likely assess in this client?

The client with an anxiety disorder is ready to be discharged from the unit.What should the nurse plan to teach this client and family in preparation for discharge? Select all that apply.

The nurse instructs a client with a history of acute respiratory acidosis and lung infections on ways to prevent further episodes of the health problem.Which client statement indicates that teaching has been effective?

The nurse has completed discharge teaching for a client with an anxiety disorder.Which client statement indicates that client teaching about respiratory alkalosis has been effective?

The nurse is providing care to a client recently extubated for treatment of aspiration pneumonia and respiratory acidosis.Which action by the nurse provides an optimum environment for this client?

A client is admitted to the hospital with sudden,severe abdominal pain.The client is diagnosed with respiratory alkalosis.Which arterial blood gas value does the nurse document to support this diagnosis?

The nurse is caring for a client who has been admitted to the unit with respiratory failure and respiratory acidosis.Which data from the nursing history would the nurse suspect contributed to the client's current state of health?

The nurse is reviewing prescriptions written for a client with chronic respiratory acidosis.Which prescription should the nurse question prior to implementation?

The nurse is planning care for a client who has been admitted to the unit with a salicylate overdose.When preparing the plan of care,the nurse considers which to be a priority nursing diagnosis?

Quiz 1: Acidbase Balance

The nurse is preparing to admit a client with acute pneumonia who is experiencing severe respiratory acidosis.Which treatments does the nurse anticipate as appropriate for this client? Select all that apply.

The nurse is reviewing new orders written for a client experiencing respiratory alkalosis.Which orders would be appropriate for this client's care needs? Select all that apply.

A client with pneumonia develops respiratory acidosis.Which medications should the nurse prepare to administer to this client? Select all that apply.

The client is admitted to the emergency department (ED) with symptoms of a panic attack,including hyperventilation.Based on this data,the nurse plans care for which health problem?

A client is admitted to the unit with chronic obstructive pulmonary disease.Blood gas analysis indicates respiratory acidosis.Based on this data,the nurse plans care based on which priority diagnosis?

The nurse is preparing discharge instructions for an older adult client recovering from respiratory acidosis caused by restrictive lung disease and pneumonia.Which topics should the nurse include in the discharge teaching for this client? Select all that apply.

The nurse is caring for a client who is being mechanically ventilated.Arterial blood gas analysis reveals a pH of 7.20 and a PaCO2 of 49 mmHg.Which change in ventilator settings should the nurse anticipate?

A client with metabolic alkalosis is experiencing numbness around the mouth and tingling of the fingers.What should the nurse explain as the reason for these manifestations?

The nurse is caring for the client with a history of anxiety who is experiencing chest pain,palpitations and dyspnea.Which intervention would be a priority for this client?

A client is admitted to the emergency department for treatment of an overdose.The client's arterial blood gas results indicate acute respiratory acidosis.Which substance found on the nurse's review of the toxicology analysis is most likely the cause for the client's current condition?

The nurse suspects a client with one functioning lung is developing chronic respiratory acidosis.Which manifestation did the nurse most likely assess in this client?

The client with an anxiety disorder is ready to be discharged from the unit.What should the nurse plan to teach this client and family in preparation for discharge? Select all that apply.

The nurse instructs a client with a history of acute respiratory acidosis and lung infections on ways to prevent further episodes of the health problem.Which client statement indicates that teaching has been effective?

The nurse has completed discharge teaching for a client with an anxiety disorder.Which client statement indicates that client teaching about respiratory alkalosis has been effective?

The nurse is providing care to a client recently extubated for treatment of aspiration pneumonia and respiratory acidosis.Which action by the nurse provides an optimum environment for this client?

A client is admitted to the hospital with sudden,severe abdominal pain.The client is diagnosed with respiratory alkalosis.Which arterial blood gas value does the nurse document to support this diagnosis?

The nurse is caring for a client who has been admitted to the unit with respiratory failure and respiratory acidosis.Which data from the nursing history would the nurse suspect contributed to the client's current state of health?

The nurse is reviewing prescriptions written for a client with chronic respiratory acidosis.Which prescription should the nurse question prior to implementation?

The nurse is planning care for a client who has been admitted to the unit with a salicylate overdose.When preparing the plan of care,the nurse considers which to be a priority nursing diagnosis?

The nurse is caring for a client who is being mechanically ventilated.Arterial blood gas analysis reveals a pH of 7.20 and a PaCO₂ of 49 mmHg.Which change in ventilator settings should the nurse anticipate?