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Chapter 10 Question 1 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? 1. Pressure from a right pneumothorax 2. Misplacement of the endotracheal tube 3. High pulmonary pressures 4. Partial obstruction of the endotracheal tube 5. A large infiltrate in the left lung Question 2 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? 1. Decreased work of breathing 2. Reduced muscle activity 3. Dehydration of lung tissues 4. Decreased compliance Question 3 The patient has been diagnosed with early stage pneumonia. The nurse would anticipate which laboratory results? 1. Increased PaO2 and increased PaCO2 2. Decreased PaO2 and normal PaCO2 3. Normal PaO2 and elevated PaCO2 4. Decreased PaO2 and increased PaCO2 Question 4 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? 1. Increase in alveolar–capillary membrane thins 2. Increase in total lung surface area 3. Increase in size of the airways 4. Increase in air trapping 5. Overgrowth of alveoli Question 5 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? 1. Flat in bed lying on the left side 2. Flat in bed lying on the right side 3. Lying on the left side with the head of the bed elevated to 30 degrees 4. Lying on the right side with the head of the bed elevated 30 degrees Question 6 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? 1. “Keep trying to slow the patient’s respirations because breathing so fast is hard on his heart.” 2. “If he keeps breathing like that he will develop respiratory acidosis.” 3. “Let the patient set his respiratory rate as rapid breathing helps to compensate for his acidosis.” 4. “The patient is breathing deeply to help offset diabetes-induced hypoxemia.” Question 7 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? 1. Metabolic alkalosis 2. Metabolic acidosis 3. Respiratory acidosis 4. Respiratory alkalosis Question 8 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? 1. Increase in pH and decrease in PaCO2 2. Increase in pH and increase in HCO3 3. Decrease in pH and increase in PaCO2 4. Decrease in pH and decrease in HCO3 Question 9 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? 1. Uncompensated respiratory alkalosis with moderate hypoxemia 2. Compensated metabolic acidosis with severe hypoxemia 3. Partially compensated metabolic acidosis with moderate hypoxemia 4. Partially compensated respiratory alkalosis with mild hypoxemia Question 10 A patient’s PaO2 level is 76 mm Hg. The nurse would be least concerned regarding this finding in which patient? 1. The patient is 83 years old. 2. The patient is recovering from anesthesia. 3. The patient is a smoker. 4. The patient is intubated.