Liza’s mother is seen in the emergency department at a community hospital. She admits that her mother is taking many tablets of aspirin (salicylates) over the last 24-hour period because of a severe headache. Also, the mother complains of an inability to urinate. The nurse on duty took her vital signs and noted the following: Temp = 97.8 °F; apical pulse = 95; respiration = 32 and deep.
Which primary acid-base imbalance is the client at risk for if medical attention is not provided?
Anonymous Quiz
27%
A. Respiratory Acidosis
9%
B. Respiratory Alkalosis
36%
C. Metabolic Acidosis
9%
D. Metabolic Alkalosis
18%
E. Mixed acidosis alkalosis
A patient who is hospitalized due to vomiting and a decreased level of consciousness displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. The doctor diagnosed him of having dehydration. Measurement of arterial blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 22 mm Hg, and HCO3 14 mmol/L; other results are Na+ 120 mmol/L, K+ 2.5 mmol/L, and Cl- 95 mmol/L.
As a knowledgeable nurse, you know that the normal value for PaCO2 is:
Anonymous Quiz
29%
A. 22 mm Hg
53%
B. 36 mm Hg
12%
C. 48 mm Hg
6%
D. 50 mm Hg
0%
E. 52mm Hg
A company driver is found at the scene of an automobile accident in a state of emotional distress. He tells the paramedics that he feels dizzy, tingling in his fingertips, and does not remember what happened to his car. Respiratory rate is rapid at 34/minute.
Which primary acid-base disturbance is the young man at risk for if medical attention is not provided?
Anonymous Quiz
29%
A. Respiratory Acidosis
43%
B. Respiratory Alkalosis
14%
C. Metabolic Acidosis
0%
D. Metabolic Alkalosis
14%
E. I don't know
An elderly client was admitted to hospital in a coma. Analysis of the arterial blood gave the following values: PCO2 16 mm Hg, HCO3- 5 mmol/L and pH 7.1. As a well-rounded nurse, you know that the normal value for HCO3 is:
Anonymous Quiz
25%
A. 20 mmol/L
69%
B. 24 mmol/L
0%
C. 29 mmol/L
0%
D. 31 mmol/L
6%
E. 35 mmol/L
In a patient undergoing surgery, it was vital to aspirate the contents of the upper gastrointestinal tract. After the operation, the following values were acquired from an arterial blood sample: pH 7.55, PCO2 52 mm Hg and HCO3- 40 mmol/l.
What is the underlying disorder?
Anonymous Quiz
18%
A. Respiratory Acidosis
23%
B. Respiratory Alkalosis
0%
C. Metabolic Acidosis
50%
D. Metabolic Alkalosis
9%
E. None of the above
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😁5
A 22-year-old university student with known bronchial asthma reports symptoms only once or twice per month. He has no nocturnal symptoms and has never been hospitalized. He currently carries a salbutamol inhaler and uses it when needed.
❤2
Which of the following is the most appropriate preferred reliever strategy?
Anonymous Quiz
54%
A. Salbutamol alone as needed
8%
B. Daily oral montelukast only
38%
C. Low-dose ICS-formoterol as needed
0%
D. Daily high-dose inhaled corticosteroid
0%
E. Oral prednisolone whenever symptoms occur
A 28-year-old woman with known asthma has been using low-dose ICS-LABA for the last 3 months. She reports daytime symptoms on 4 days per week and occasional nocturnal awakening. She insists that she takes her medication regularly. Her prescriptions have been refilled on time.
❤2
Before increasing her controller treatment, which of the following is the most appropriate next step?
Anonymous Quiz
6%
A. Increase the ICS dose immediately
19%
B. Add a leukotriene receptor antagonist
75%
C. Assess inhaler technique and other modifiable factors
0%
D. Add tiotropium
0%
E. Start a short course of oral corticosteroids
A 20-year-old woman was diagnosed with asthma six months ago. At diagnosis, she had daily symptoms and frequent nocturnal awakening. She is now completely asymptomatic on low-intensity treatment.
Which statement is most accurate?
Anonymous Quiz
16%
A. Daily symptoms at presentation permanently classify her asthma as severe
11%
B. The number of wheezing episodes determines asthma severity
26%
C. Asthma severity should be determined before any treatment is given
42%
D. Asthma severity is assessed mainly by the level of treatment required to maintain control
5%
E. Any previous nocturnal symptoms indicate severe asthma
❤1
A 24-year-old man with known asthma presents with a severe exacerbation. On arrival, he is tachypneic and anxious. His initial ABG shows:
pH 7.47
PaCO₂ 29 mmHg
PaO₂ 72 mmHg
One hour later, he appears quieter and his respiratory rate falls from 34 to 22/min. Repeat ABG shows:
pH 7.35
PaCO₂ 44 mmHg
PaO₂ 68 mmHg
pH 7.47
PaCO₂ 29 mmHg
PaO₂ 72 mmHg
One hour later, he appears quieter and his respiratory rate falls from 34 to 22/min. Repeat ABG shows:
pH 7.35
PaCO₂ 44 mmHg
PaO₂ 68 mmHg
What is the most appropriate interpretation?
Anonymous Quiz
9%
A. His respiratory rate has normalized, indicating improvement
20%
B. The second ABG demonstrates appropriate physiological compensation
66%
C. The rising PaCO₂ suggests respiratory muscle fatigue and impending ventilatory failure
3%
D. The change represents resolution of respiratory alkalosis
3%
E. The fall in respiratory rate indicates reduced bronchospasm
❤2