MDC II Exam 2

1. A patient is brought into the ED with respiratory depression. The patient has a history of

COPD. What acid-base imbalance is most likely?

- Respiratory Acidosis. The patient likely has a build-up of CO2, causing respiratory

acidosis.

2. The nurse is evaluating the lab work of a patient who has uncontrolled metabolic

acidosis. Which lab result would result from this condition?

A) pH 7.4

B) PaO2 98 mm Hg

C) bicarbonate 38 mEq/ L

D) serum potassium 5.7 mEq/L

- D) serum potassium 5.7 mEq/L. Serum potassium increases during acidosis to try to

buffer the acidic conditions.

3. The nurse is reviewing the standing orders for a patient who was admitted for

evaluation of chest pain. The patient has a history of chronic obstructive pulmonary

disease (COPD) and his laboratory results and assessment reveal that he has mild

respiratory acidosis. The nurse would question which order?

A.Encourage oral fluids

B.Keep head of bed elevated

C.Oxygen therapy at 4 L/min as needed

D.Bedrest with bathroom privileges only

- C) Oxygen therapy at 4L/ Min as needed. Oxygen therapy is often ordered for

respiratory acidosis. However, COPD patients have a difficult time off-loading carbon

dioxide and giving too much oxygen can cause these patients to have a decrease in

respiratory drive, leading to respiratory arrest.

4. A client has acute alcohol intoxication. What acid-base imbalance is the client at risk for?

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- metabolic acidosis.

5. A client comes into the ED with respiratory acidosis. What type of medication would the

nurse likely administer?

- bronchodilators

6. A client comes into the ED with a high fever and is hyperventilating. His ABG results are

pH 7.51, PaCO2 28 mm Hg, and HCO3 24 mEq/L. The nurse should identify that the

client has which acid-base imbalance?

- Respiratory Alkalosis. Because the client is breathing rapidly, he is exhaling excessive

amounts of carbon dioxide. This loss of carbon dioxide decreases the hydrogen ion level

of the blood, causing the pH to increase and resulting in respiratory alkalosis.

7. A nurse is caring for a client who has metabolic alkalosis. As the client compensates for

this acid-base imbalance, which of the following mechanisms should the nurse expect

the client's body to use?

- Hypoventilation.

Hypoventilation is the mechanism that helps clients compensate for metabolic alkalosis.

8. A nurse is inserting an NG tube for a client who is beginning enteral feedings. What

action should the nurse take to verify tube placement before administering initial

feeding?

- Verify tube placement with radiography

9. Which patient statement alerts the nurse to perform a thorough GI history and focused

assessment?

A."I don't like the taste of spicy foods."

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B."I got dentures four years ago."

C."I experience occasional constipation."

D."I take ibuprofen three times daily for arthritis."

- D. large amounts of aspirin or NSAIDs can cause peptic ulcer disease and GI bleeding.

10. After abdominal surgery, which question should the nurse ask the patient to determine

whether peristaltic movement is returning?

A."Have you passed flatus?"

B."Are you hungry"

C."Do you have any nausea?"

D."Is your pain level manageable?"

- A). Passing gas is evidence of peristaltic movement

11. When administering a new GI medication to an older patient, the nurse anticipates

what?

A.A higher-than-normal dose may be needed.

B.Close monitoring is needed because toxic levels may develop.

C.Older adults always require a lower-than-normal dose than younger patients.

Nausea and vomiting may develop rapidly and are common side effects in older adults

- B.Close monitoring is needed because toxic levels may develop.

12. A patient in the ED has been experiencing upper abdominal pain after meals for the past

several months. She reports pain after napping or sleeping at night. She has been taking

OTC antacids with some relief. The nurse understands that which assessment finding

places the patient at risk for peptic ulcer disease?

A.GERD 4 years ago

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