1. A client admitted to the hospital has these arterial blood gas (ABG) results: pH 7.50; PaCO 2
PaCO2 40; HCO − 3 HCO3− 29. Which question should the nurse ask the client to help
determine an etiology for these results?
a. "Have you had diarrhea lately?"
b. "Do you have a history of COPD?"
c. "How long have you had nausea and vomiting?"
d. "Do you smoke?" –
ANS-Answer: C; ABG results reflect elevated pH, indicating alkalosis, and normal PaCO 2
PaCO2 and an increased HCO − 3 , HCO3−, indicating metabolic alkalosis. Vomiting is a
common cause of this condition. The presence of diarrhea is associated with metabolic acidosis.
COPD is associated with respiratory acidosis. Smoking can be associated with respiratory
acidosis if it leads to respiratory disease.
2. A client asks the nurse why beclomethasone was prescribed for his chronic obstructive
pulmonary disease (COPD). Which statement by the nurse is most appropriate?
a. "Beclomethasone prevents airway dilation."
b. "Beclomethasone decreases inflammation, and makes it easier to breathe."
c. "Beclomethasone suppresses the immune response."
d. "Beclomethasone decreases responsiveness to medications that dilate the airway." – ANSAnswer: B; Beclomethasone is an inhaled corticosteroid that is thought to decrease inflammation
and dilate the airway. Preventing airway dilation is undesirable for this client, and the exact
opposite action of beclomethasone. The exact mechanism of action is unknown.
Beclomethasone, like any other corticosteroid, does suppress the immune response, but this is
not the rationale for administration of the medication. Inhaled corticosteroids are thought to
increase responsiveness of bronchial smooth muscle to beta-agonist drugs.
3.A client is hospitalized with a diagnosis of pneumonia. Which findings, based on the nurse's
knowledge, are indicative of a deteriorating clinical state? Select all that apply.
a. Increased respiratory rate
b. Tachycardia
c. Agitation
d. Cyanosis
e. Increased urinary output – ANSAnswer: A, B, C, D; Increased respiratory rate, tachycardia, and agitation are early signs of
respiratory distr
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