Question 1

Which of the following ABG values represents uncompensated metabolic acidosis?

Accepted Answer

A)   pH, 7.29; PaCO2, 57 mm Hg; HCO3-, 22 mEq/L
B)   pH, 7.36; PaCO2, 33 mm Hg; HCO3-, 18 mEq/L
C)   pH, 7.22; PaCO2, 42 mm Hg; HCO3-, 18 mEq/L
D)   pH, 7.52; PaCO2, 38 mm Hg; HCO3-, 29 mEq/L C

Question 2

Severe coughing and shortness of breath during a thoracentesis are indicative of which of the following complications?

Accepted Answer

A)   Re-expansion pulmonary edema
B)   Pleural infection
C)   Pneumothorax
D)   Hemothorax A

Question 3

A patient's assessment data present as follows: pH,7.10; PaCO2,60 mm Hg; PaO2,40 mm Hg; HCO3-,24 mEq/L; RR,34 breaths/min; HR,128 beats/min; and BP,180/92 mm Hg.This condition is best described as

Accepted Answer

A)   uncompensated respiratory acidosis.
B)   uncompensated metabolic acidosis.
C)   compensated metabolic acidosis.
D)   compensated respiratory acidosis. A

Question 4

On admission,a patient presents as follows: pH,7.38; respiratory rate,24 breaths/min,regular,pursed-lip breathing; PaO2,66 mm Hg; heart rate,112 beats/min,sinus tachycardia; PaCO2,52 mm Hg; blood pressure,110/68 mm Hg; HCO3-,24 mEq/L; and SpO2,90% on O2 2 L/min nasal cannula.Which of the following diagnoses would be most consistent with the above arterial blood gas values?

Accepted Answer

A)   Acute pulmonary embolism
B)   Acute myocardial infarction
C)   Congestive heart failure
D)   Chronic obstructive pulmonary disease

Question 5

Risk factors that need to be considered with thoracentesis include

Accepted Answer

A)   coagulation defects.
B)   intra-aortic balloon pump.
C)   pleural effusion.
D)   uncooperative patient.
E)   empyema.

Question 6

A 75-kg,5 foot,8 inch patient is on a ventilator.The physician or nurse practitioner states the patient may be ready for extubation.Orders for a negative inspiratory pressure (NIP)and force ventilatory capacity (FVC)tests are written.Which of the following results best suggests that the patient is ready for extubation?

Accepted Answer

A)   NIP, -10; FVC, 4600
B)   NIP, -18; FVC, 4700
C)   NIP, -22; FVC, 4400
D)   NIP, -24; FVC, 4800

Question 7

Which of the following ABG values reflects compensation?

Accepted Answer

A)   pH, 7.26; PaCO2, 55 mm Hg; HCO3-, 24 mEq/L
B)   pH, 7.30; PaCO2, 32 mm Hg; HCO3-, 18 mEq/L
C)   pH, 7.48; PaCO2, 30 mm Hg; HCO3-, 22 mEq/L
D)   pH, 7.38; PaCO2, 58 mm Hg; HCO3-, 30 mEq/L

Question 8

V/Q scans are ordered to evaluate the possibility of which of the following?

Accepted Answer

A)   Pulmonary emboli
B)   Acute myocardial infarction
C)   Emphysema
D)   Acute respiratory distress syndrome

Question 9

Determination of oxygenation status by oxygen saturation alone is inadequate.What other value must be known?

Accepted Answer

A)   pH
B)   PaCO2
C)   HCO3-
D)   Hemoglobin (Hgb)

Question 10

A patient is admitted with acute respiratory failure attributable to pneumonia.Smoking history reveals that the patient smoked two packs of cigarettes a day for 25 years,stopping 10 years ago.ABG values on the current ventilator settings are pH,7.37; PaCO2,50 mm Hg; and HCO3-,27 mEq/L.Chest radiograph reveals a large right pleural effusion.Intrapulmonary shunting value of 35% indicates

Accepted Answer

A)   normal gas exchange of venous blood.
B)   an abnormal finding indicative of a shunt-producing disorder.
C)   a serious and potentially life-threatening condition.
D)   metabolic alkalosis.

Question 11

A patient is admitted with acute respiratory failure attributable to pneumonia.Smoking history reveals that the patient smoked two packs of cigarettes a day for 25 years,stopping 10 years ago.ABG values on the current ventilator settings are pH,7.37; PaCO2,50 mm Hg; and HCO3-,27 mEq/L.Chest radiography reveals a large right pleural effusion.Which of the following is the correct interpretation of the patient's ABG values?

Accepted Answer

A)   Compensated respiratory acidosis
B)   Compensated metabolic alkalosis
C)   Uncompensated respiratory alkalosis
D)   Uncompensated metabolic acidosis

Question 12

A patient is intubated,and sputum for culture and sensitivity is ordered.Which of the following is important for obtaining the best specimen?

Accepted Answer

A)   After the specimen is in the container, dilute thick secretions with sterile water.
B)   Apply suction when the catheter is advanced to obtain secretions from within the endotracheal tube.
C)   Do not apply suction while the catheter is being withdrawn because this can contaminate the sample with sputum left in the endotracheal tube.
D)   Do not clear the endotracheal tube of all local secretions before obtaining the specimen.

Question 13

A patient presents moderately short of breath and dyspneic.A chest radiographic examination reveals a large right pleural effusion with significant atelectasis.The physician or nurse practitioner would be most likely to order which of the following procedures?

Accepted Answer

A)   Thoracentesis
B)   Bronchoscopy
C)   Ventilation/perfusion (V/Q)  scan
D)   Repeat chest radiograph

Question 14

A static lung compliance of 40 mL/cm H2O is indicative of which of the following disorders?

Accepted Answer

A)   Pneumonia
B)   Bronchospasm
C)   Pulmonary emboli
D)   Upper airway obstruction

Question 15

Which of the following signs or symptoms would be most consistent with the following values? pH,7.20; pO2,106 mm Hg; pCO2,35 mm Hg; HCO3-,11 mEq/L.

Accepted Answer

A)   Diarrhea
B)   Shortness of breath
C)   Central cyanosis
D)   Peripheral cyanosis

Question 16

On admission,a patient presents as follows: pH,7.38; respiratory rate,24 breaths/min,regular,pursed-lip breathing; PaO2,66 mm Hg; heart rate,112 beats/min,sinus tachycardia; PaCO2,52 mm Hg; blood pressure,110/68 mm Hg; HCO3-,24 mEq/L; and SpO2,90% on O2 2 L/min nasal cannula.What treatment would the physician or nurse practitioner likely order for this patient?

Accepted Answer

A)   Increase O2 to 6 L/min.
B)   Prepare for emergency intubation.
C)   Administer 1 ampule of sodium bicarbonate.
D)   Repeat ABG testing in 4 hours.

Question 17

For which of the following conditions is a bronchoscopy indicated?

Accepted Answer

A)   Pulmonary edema
B)   Ineffective clearance of secretions
C)   Upper gastrointestinal bleed
D)   Instillation of surfactant

Question 18

On admission,a patient presents as follows: pH,7.38; respiratory rate,24 breaths/min,regular,pursed-lip breathing; PaO2,66 mm Hg; heart rate,112 beats/min,sinus tachycardia; PaCO2,52 mm Hg; blood pressure,110/68 mm Hg; HCO3-,24 mEq/L; and SpO2,90% on O2 2 L/min nasal cannula.These gases show

Accepted Answer

A)   uncompensated metabolic alkalosis.
B)   uncompensated respiratory acidosis.
C)   compensated metabolic acidosis.
D)   compensated respiratory alkalosis.

Question 19

A patient's pulse oximeter alarm goes off.The monitor reads 82%.What is the first action the nurse should perform?

Accepted Answer

A)   Prepare to intubate.
B)   Assess the patient's condition.
C)   Turn off the alarm and reapply the oximeter sensor.
D)   Increase O2 level to 4L/NC.

Question 20

A patient presents with the following values: pH,7.20; pO2,106 mm Hg; pCO2,35 mm Hg; and HCO3-,11 mEq/L.These values are most consistent with

Accepted Answer

A)   uncompensated respiratory acidosis.
B)   uncompensated metabolic acidosis.
C)   uncompensated metabolic alkalosis.
D)   uncompensated respiratory alkalosis.

Exam 19: Pulmonary Diagnostic Procedures