Quiz 16: Gas Exchange

Concepts For Nursing Practice

Nursing
10
Questions
0
True/False
8
Choices
2
Essay
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Questions

Q1
Free

The nurse is assigned a group of patients. Which patient would the nurse identify as being at increased risk for impaired gas exchange? A patient

Multiple Choice
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A) with a blood glucose of 350 mg/dL
B) who has been on anticoagulants for 10 days
C) with a hemoglobin of 8.5 g/dL
D) with a heart rate of 100 beats/min and blood pressure of 100/60
Answer:
C) with a hemoglobin of 8.5 g/dL

Explanation:
The hemoglobin is low (anemia), therefore the ability of the blood to carry oxygen is decreased. High blood glucose and/or anticoagulants do not alter the oxygen carrying capacity of the blood. A heart rate of 100 beats/min and blood pressure of 100/60 are not indicative of oxygen carrying capacity of the blood.
Q2
Free

The nurse is reviewing the patients arterial blood gas results. The PaO2 is 96 mm Hg, pH is 7.20, PaCO2 is 55 mm Hg, and HCO3 is 25 mEq/L. What would the nurse expect to observe on assessment of this patient?

Multiple Choice
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A) Disorientation and tremors
B) Tachycardia and decreased blood pressure
C) Increased anxiety and irritability
D) Hyperventilation and lethargy
Answer:
A) Disorientation and tremors

Explanation:
The patient is experiencing respiratory acidosis ( pH, and PaCO2 ) which may be manifested by disorientation, tremors, possible seizures, and decreased level of consciousness. Tachycardia and decreased blood pressure are not characteristic of a problem of respiratory acidosis. Increased anxiety and hyperventilation will cause respiratory alkalosis, which is manifested by an increase in pH and a decrease in PaCO2.
Q3
Free

The nurse would identify which patient as having a problem of impaired gas exchange secondary to a perfusion problem? A patient with

Multiple Choice
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A) peripheral arterial disease of the lower extremities
B) chronic obstructive pulmonary disease (COPD)
C) chronic asthma
D) severe anemia secondary to chemotherapy
Answer:
A) peripheral arterial disease of the lower extremities

Explanation:
Perfusion relates to the ability of the blood to deliver oxygen to the cellular level and return the carbon dioxide to the lung for removal. COPD and asthma are examples of a ventilation problem. Severe anemia is an example of a transport problem of gas exchange.
Q4

The nurse is assessing a patients differential white blood cell count. What implications would this test have on evaluating the adequacy of a patients gas exchange?

Multiple Choice
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A) An elevation of the total white cell count indicates generalized inflammation.
B) Eosinophil count will assist to identify the presence of a respiratory infection.
C) White cell count will differentiate types of respiratory bacteria.
D) Level of neutrophils provides guidelines to monitor a chronic infection.
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Q5

The acid-base status of a patient is dependent on normal gas exchange. Which patient would the nurse identify as having an increased risk for the development of respiratory acidosis? A patient with

Multiple Choice
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A) chronic lung disease with increased carbon dioxide retention
B) acute anxiety, hyperventilation, and decreased carbon dioxide retention
C) decreased cardiac output with increased serum lactic acid production
D) gastric drainage with increased removal of gastric acid
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Q6

Which patient would the nurse identify as being at an increased risk for altered transport of oxygen? A patient with

Multiple Choice
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A) hemoglobin level of 8.0
B) bronchoconstriction and mucus
C) peripheral arterial disease
D) decreased thoracic expansion
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Q7

A 3-month-old infant is at increased risk for developing anemia. The nurse would identify which principle contributing to this risk?

Multiple Choice
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A) The infant is becoming more active.
B) There is an increase in intake of breast milk or formula.
C) The infant is unable to maintain an adequate iron intake.
D) A depletion of fetal hemoglobin occurs.
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Q8

Which clinical management prevention concept would the nurse identify as representative of secondary prevention?

Multiple Choice
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A) Decreasing venous stasis and risk for pulmonary emboli
B) Implementation of strict hand washing routines
C) Maintaining current vaccination schedules
D) Prevention of pneumonia in patients with chronic lung disease
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Q9

[Multiple Response] The nurse would identify which body systems as directly involved in the process of normal gas exchange? (Select all that apply.)
a. Neurologic system
b. Endocrine system
c. Pulmonary system
d. Immune system
e. Cardiovascular system
f. Hepatic system

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Q10

[Multiple Response] The nurse is assessing a patient for the adequacy of ventilation. What assessment findings would indicate the patient has good ventilation? (Select all that apply.)
a. Respiratory rate is 24 breaths/min.
b. Oxygen saturation level is 98%.
c. The right side of the thorax expands slightly more than the left.
d. Trachea is just to the left of the sternal notch.
e. Nail beds are pink with good capillary refill.
f. There is presence of quiet, effortless breath sounds at lung base bilaterally.

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